Individual provider Active NPI

Olufunmilayo O. Ekundare, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Katy, TX
National Provider Identifier
1114794260
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1143298 Issued in TX
Practice address
25022 Florina Ranch Dr
Katy, TX 77494-5274
Phone
(832) 495-7717
NPI assigned
Dec 8, 2023
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1143298 TX Primary

Addresses

Primary practice location

25022 Florina Ranch Dr
Katy, TX 77494-5274

Mailing address

25022 Florina Ranch Dr
Katy, TX 77494-5274
Phone (832) 495-7717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121000319 TX Practitioner - Nurse Practitioner 9931638913 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1143298TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ark of Blessings Home Health Services, LLC. CurrentSince Oct 6, 2025 Accepting new patients
G&a Wellness Medical Clinic, PLLC CurrentSince Dec 16, 2024 Accepting new patients

Locations

1500 S Dairy Ashford Rd
Ste 200
Houston, TX 77077
Phone (281) 208-7414

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ark of Blessings Home Health Services LLCHouston, TX, CCN 748161 Home health agency Corporate Director
Other
Oct 6, 2025
Aug 12, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1114794260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25022 FLORINA RANCH DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945274",
            "telephone_number": "832-495-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25022 FLORINA RANCH DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945274",
            "telephone_number": "832-495-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKUNDARE",
        "first_name": "OLUFUNMILAYO",
        "middle_name": "O.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1143298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.