Provider Demographics
NPI:1558843300
Name:OGUNJIMI, THERESA OMOTOYOSI (NP)
Entity type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:OMOTOYOSI
Last Name:OGUNJIMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18622 GREENWOOD MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4606
Mailing Address - Country:US
Mailing Address - Phone:713-922-0343
Mailing Address - Fax:
Practice Address - Street 1:18622 GREENWOOD MEADOW TRL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4606
Practice Address - Country:US
Practice Address - Phone:713-922-0343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1203981363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty