Olufunke Olufeyi Idonor

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP128077 Issued in TX

Practice address

9401 Southwest Fwy
Houston, TX 77074-1407

Phone

(713) 970-7000

NPI assigned

May 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Harris Center for Mental Health and IddGroup PAC ID 9739088790, 122 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• The Harris Center for Mental Health and Idd

  • Community/Behavioral Health Agency
  • Houston, TX
  • NPI 1346293156

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1669850087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14706 RICH VALLEY LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774985031",
            "telephone_number": "281-988-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDONOR",
        "first_name": "OLUFUNKE",
        "middle_name": "OLUFEYI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idjagboro Healthcare and Medical Services Inc
• Damian Okpako Idjagboro, PA-C
• Idoc Telehealth Solutions, Inc
• Idoc Virtual Telehealth Texas
• Idocs OD PA
• Mary Boluwatife Idowu, M.D.
• Modupe Idowu, M.D.
• Olakunle Idowu, M.D.
• Queen Idowu, PMHNP
• Techecia Tamara Idowu, M.D.

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.