Provider Demographics
NPI:1871115261
Name:OKUNDAYE, ULOMA UDEZE (NP)
Entity type:Individual
Prefix:MRS
First Name:ULOMA
Middle Name:UDEZE
Last Name:OKUNDAYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 GASTON RD STE 150-102
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7941
Mailing Address - Country:US
Mailing Address - Phone:818-571-8676
Mailing Address - Fax:
Practice Address - Street 1:4114 AVENUE H
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2833
Practice Address - Country:US
Practice Address - Phone:281-725-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX891744163W00000X
TNAP145527363LF0000X
TXAP145973363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily