Healthcare Provider Details

I. General information

NPI: 1740083492
Provider Name (Legal Business Name): ABIMBOLA OGUNLEYE MSN, APRN, FNP-BC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 GESSNER RD
HOUSTON TX
77080-2503
US

IV. Provider business mailing address

2925 RICHMOND AVE STE 1200
HOUSTON TX
77098-3143
US

V. Phone/Fax

Practice location:
  • Phone: 512-913-9878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1181872
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: