Omobola Abosede Petinrin, FNP
Individual provider Active NPI Family Medicine Physician · Waller, TX
NPI 1669986196 · NPPES record last updated Jan 8, 2026
Key facts
- NPI
- 1669986196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- AP134723 (TX)
- Practice address
- 1225 Farr St
Waller, TX 77484-8486 - Phone
- (936) 372-3003
- Fax
- (936) 372-8070
- NPI assigned
- Nov 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freedomchoice Family Clinic | Family Medicine | Current | Accepting new patients |
| Freedomchoice Health | Past |
Accepting new patients |
Locations
1225 Farr St
Waller, TX 77484
Phone (936) 372-3003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AP134723 | TX | Yes |
Addresses
Primary practice location
1225 Farr St
Waller, TX 77484-8486
Mailing address
12822 Shadow Canyon LN
Pearland, TX 77584-3640
Phone (646) 441-0897
Other providers in Waller, TX
- Melanie Oslund-Goldberg
- Lindsay Shay Owen
- Lorena Penaloza
- Jessenia N Perea
- Victor Alexander Perea
- Anthony Tam Pham
- Anthony Guy Pizzino
- Kristina Port
- Junious Keith Powell
- Crystal Prince
All providers in Waller, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.