Individual
MR. JIDE OMOSEWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 E MOCKINGBIRD LN, SUITE 101, VICTORIA, TX 77904-2155
(361) 573-6291
(361) 576-2434
Mailing address
1501 E MOCKINGBIRD LN, SUITE 101, VICTORIA, TX 77904-2155
(361) 573-6291
(361) 576-2434
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024169214
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
869357
TX
367500000X
Certified Registered Nurse Anesthetist
CRNA1477
AZ
Other
Enumeration date
02/18/2011
Last updated
07/20/2021
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