MEDICARE: COSANDRA OWOLABI

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
1	251E00000X	Home Health Agency	11949118	TX

General Provider Information

NPI Number	:	1407611841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COSANDRA OWOLABI

Provider Business Mailing Address
First Line	:	8234 SOLARA BND
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5156
Country	:	US
Telephone Number	:	281-682-3839
Fax Number	:

Provider Business Practice Location Address
First Line	:	8234 SOLARA BND
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5156
Country	:	US
Telephone Number	:	281-682-3839
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2024
Last Update Date	:	02/15/2024

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Directions to “ COSANDRA OWOLABI ” Practice Location

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