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NPI Code Detail

MEDICARE: OLAKUNLE OMIYALE

MEDICARE:   OLAKUNLE  OMIYALE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1063038495
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLAKUNLE OMIYALE
Provider Business Mailing Address
First Line : 2620 TANGLEWILDE ST STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77063-3203
Country : US
Telephone Number : 832-275-9109
Fax Number :
Provider Business Practice Location Address
First Line : 2620 TANGLEWILDE ST STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77063-3203
Country : US
Telephone Number : 832-275-9109
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2020
Last Update Date : 06/22/2020

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Directions to “ OLAKUNLE OMIYALE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.