Provider Demographics
NPI:1598307522
Name:IKUOPENIKAN, OLUJIMI
Entity type:Individual
Prefix:
First Name:OLUJIMI
Middle Name:
Last Name:IKUOPENIKAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 FALCON BROOK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7375
Mailing Address - Country:US
Mailing Address - Phone:832-681-0706
Mailing Address - Fax:
Practice Address - Street 1:9645 BARKER CYPRESS RD STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5292
Practice Address - Country:US
Practice Address - Phone:346-250-6010
Practice Address - Fax:346-200-3572
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142626163WD1100X, 163WH0500X, 163WN0300X, 363LA2100X, 363LA2200X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily