Provider Demographics
NPI:1548538820
Name:AWOLAJA, TOLULOPE OMOLAYO (GNP-BC)
Entity type:Individual
Prefix:
First Name:TOLULOPE
Middle Name:OMOLAYO
Last Name:AWOLAJA
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:TOLULOPE
Other - Middle Name:
Other - Last Name:OMOLAYO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8471 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5001
Mailing Address - Country:US
Mailing Address - Phone:832-709-2770
Mailing Address - Fax:832-924-0113
Practice Address - Street 1:8471 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5001
Practice Address - Country:US
Practice Address - Phone:832-709-2770
Practice Address - Fax:832-924-0113
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01943363LG0600X
TX760427363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM309453YUD3OtherMEDICARE PTAN