Healthcare Provider Details

I. General information

NPI: 1740215029
Provider Name (Legal Business Name): ROSEMARY O OBUDULU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12315 EVENING BAY DR
PEARLAND TX
77584-8829
US

IV. Provider business mailing address

8325 BROADWAY ST # 202-281
PEARLAND TX
77581-5772
US

V. Phone/Fax

Practice location:
  • Phone: 832-367-9620
  • Fax:
Mailing address:
  • Phone: 832-865-6806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM5416
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM5416
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01057205A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: