Provider Demographics
NPI:1255943742
Name:OGUNMAKIN, TAIYE O (PHARMD)
Entity type:Individual
Prefix:
First Name:TAIYE
Middle Name:O
Last Name:OGUNMAKIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 MID LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3845
Mailing Address - Country:US
Mailing Address - Phone:713-884-0562
Mailing Address - Fax:
Practice Address - Street 1:1812 CENTRE CREEK DR STE 115
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5133
Practice Address - Country:US
Practice Address - Phone:512-579-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist