Healthcare Provider Details

I. General information

NPI: 1407779846
Provider Name (Legal Business Name): DAVID TOLULOPE OLAGBEMI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25414 KINGSLAND BLVD STE 100
KATY TX
77494-8705
US

IV. Provider business mailing address

2405 PALMER CIR STE 100
NORMAN OK
73069-6351
US

V. Phone/Fax

Practice location:
  • Phone: 346-698-2900
  • Fax: 346-698-2900
Mailing address:
  • Phone: 346-698-2900
  • Fax: 346-698-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: