Individual
MRS. ABISOYE IFASEYI ODUTAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1201 S. ALEN GENOA RD, SOUTH HOUSTON, TX 77587
(713) 910-0000
(713) 910-0004
Mailing address
1201 S. ALEN GENOA RD, SOUTH HOUSTON, TX 77587
(713) 910-0000
(713) 910-0004
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP121759
TX
363LP2300X
Primary Care Nurse Practitioner
AP121759
TX
Other
Enumeration date
06/11/2013
Last updated
08/29/2024
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