Individual
MS. OMOBOLAJI ALLYSON AWONIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4100 DUVAL RD STE 200, AUSTIN, TX 78759-3550
(855) 876-7246
(855) 277-5070
Mailing address
PO BOX 208354, DALLAS, TX 75320-8354
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1019549
TX
363LF0000X
Family Nurse Practitioner
95011572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019549
TEXAS NP LICENSE
TX
01
—
1M9194
TEXAS MEDICARE PTAN
TX
01
—
1M9195
TEXAS MEDICARE PTAN
TX
01
—
1M9200
TEXAS MEDICARE PTAN
TX
Enumeration date
05/23/2019
Last updated
03/10/2023
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