Healthcare Provider Details

I. General information

NPI: 1831534890
Provider Name (Legal Business Name): MR. OPEOLUWA OLAORE OLOYEDE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2013
Last Update Date: 05/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N SAM HOUSTON PKWY E SUITE 360B
HOUSTON TX
77060-4037
US

IV. Provider business mailing address

525 N SAM HOUSTON PKWY E SUITE 360B
HOUSTON TX
77060-4037
US

V. Phone/Fax

Practice location:
  • Phone: 281-652-5358
  • Fax:
Mailing address:
  • Phone: 281-652-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: