1952676595 NPI number — OLAJUMOKE DADA FNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952676595 NPI number — OLAJUMOKE DADA FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DADA
Provider First Name:
OLAJUMOKE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DADA
Provider Other First Name:
OLAJUMOKE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952676595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20133 ANNA BLUE CREST CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKSHIRE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77423-2728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-666-5873
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FAMILY SURE HEALTH CLINIC
Provider Second Line Business Practice Location Address:
9207 COUNTRY CREEK ST. SUITE 105
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-888-9458
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP142602 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)