Healthcare Provider Details

I. General information

NPI: 1669546024
Provider Name (Legal Business Name): MONSUART A OGUNLANA D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MR. MANSUR KOLA OGUNLANA

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CRAWFORD ST STE 1100
HOUSTON TX
77002-9000
US

IV. Provider business mailing address

15706 ROSEWOOD HILL CT
SUGAR LAND TX
77478-7168
US

V. Phone/Fax

Practice location:
  • Phone: 713-658-1000
  • Fax: 713-658-1004
Mailing address:
  • Phone: 281-568-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009486
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: