Healthcare Provider Details

I. General information

NPI: 1760619274
Provider Name (Legal Business Name): MS. CHRISTIANAH FOLUKE OKUNADE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 12/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11325 PEGASUS ST STE E138
DALLAS TX
75238-5219
US

IV. Provider business mailing address

11325 PEGASUS ST STE E138
DALLAS TX
75238-5219
US

V. Phone/Fax

Practice location:
  • Phone: 214-221-4900
  • Fax: 214-221-4908
Mailing address:
  • Phone: 214-221-4900
  • Fax: 214-221-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: