Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1322054 | TX |
NPI | 1245838408 |
---|---|
Provider Name | Mayowa Victor Oyelami |
First Address | Houston, TX 77004-8004 |
Second Address | Houston, TX 77004-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2020 |
Last Update Date | 10/10/2020 |