Provider Demographics
NPI:1649542093
Name:ODUKOYA, YEWANDE (PT)
Entity type:Individual
Prefix:
First Name:YEWANDE
Middle Name:
Last Name:ODUKOYA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7322 SOUTHWEST FWY STE 1070
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2059
Mailing Address - Country:US
Mailing Address - Phone:281-725-0734
Mailing Address - Fax:
Practice Address - Street 1:7322 SOUTHWEST FWY STE 1070
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2059
Practice Address - Country:US
Practice Address - Phone:281-725-0734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor