Provider Demographics
NPI:1982831954
Name:OMOLOLA, CLARA NKEMJIKA (APRN)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:NKEMJIKA
Last Name:OMOLOLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13111 WESTHEIMER RD STE 340
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5526
Mailing Address - Country:US
Mailing Address - Phone:281-935-2424
Mailing Address - Fax:866-936-6638
Practice Address - Street 1:13111 WESTHEIMER RD STE 340
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5526
Practice Address - Country:US
Practice Address - Phone:281-935-2424
Practice Address - Fax:866-936-6638
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132026363L00000X
373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner