Individual
MODUPE OLUWATOYIN IDOWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 S CARRIER PKWY, GRAND PRAIRIE, TX 75051-3702
(972) 433-0088
(972) 730-9801
Mailing address
7305 ASTER DR, VENUS, TX 76084-3776
(130) 180-6611
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1124176
TX
Other
Enumeration date
02/09/2024
Last updated
04/28/2026
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