Healthcare Provider Details

I. General information

NPI: 1487150637
Provider Name (Legal Business Name): SABAINAH OGUNRINADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 FABER DR
PFLUGERVILLE TX
78660-4929
US

IV. Provider business mailing address

1229 FABER DR
PFLUGERVILLE TX
78660-4929
US

V. Phone/Fax

Practice location:
  • Phone: 512-751-3290
  • Fax: 512-252-2281
Mailing address:
  • Phone: 512-751-3290
  • Fax: 512-252-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP135187
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: