Provider Demographics
NPI:1023615218
Name:IDOWU, TEMITOPE
Entity type:Individual
Prefix:MR
First Name:TEMITOPE
Middle Name:
Last Name:IDOWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 GARDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7393
Mailing Address - Country:US
Mailing Address - Phone:713-298-1029
Mailing Address - Fax:
Practice Address - Street 1:4411 GARDEN RIDGE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7393
Practice Address - Country:US
Practice Address - Phone:713-298-1029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide