MR. SAMUEL OLAOLUWA OMOLADE APRN PMHNP NPI 1548799141

NPI Information

  • NPI: 1548799141
  • Provider Name: MR. SAMUEL OLAOLUWA OMOLADE, APRN PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11650 MCCREE RD
    DALLAS, TX
    ZIP 75238
  • Phone: (718) 304-4906

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NPI Details

MR. Samuel Olaoluwa Omolade, APRN PMHNP is a psychiatric/mental health nurse practitioner in Dallas, TX with 5 years of experience. MR. Samuel Olaoluwa Omolade, APRN PMHNP NPI is 1548799141. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11650 MCCREE RD
DALLAS, TX
ZIP 75238-224
Phone: (718) 304-4906

The NPI 1548799141 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2017 and was last updated on 7/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse320878-1NEW YORKNo
2163WA2000XRegistered NurseAdministrator958104TEXASNo
3171M00000XCase Manager/Care Coordinator958104TEXASNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthAP61366158WASHINGTONNo
5363LP0808XNurse PractitionerPsychiatric/Mental Health1099855TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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