Provider Demographics
NPI:1598553141
Name:KUJORE, OLUWATOSIN
Entity type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:
Last Name:KUJORE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 W BELLFORT AVE APT 1213
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4842
Mailing Address - Country:US
Mailing Address - Phone:346-524-5451
Mailing Address - Fax:
Practice Address - Street 1:11240 FM 1960 RD W STE 209
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3664
Practice Address - Country:US
Practice Address - Phone:801-758-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician