MEDICARE: KOLAWOLE LADIPO & DELOISE WILSON-LADIPO

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

General Provider Information

NPI Number	:	1487732699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOLAWOLE LADIPO & DELOISE WILSON-LADIPO

Provider Business Mailing Address
First Line	:	6023 COVENTRY FLS
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6390
Country	:	US
Telephone Number	:	832-541-9224
Fax Number	:	281-667-3213

Provider Business Practice Location Address
First Line	:	6023 COVENTRY FLS
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6390
Country	:	US
Telephone Number	:	832-541-9224
Fax Number	:	281-667-3213

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KOLAWOLE LADIPO
Credential	:
Telephone Number	:	832-541-9224

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/22/2020

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