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General NPI Number Information
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NPI Number | 1275861528
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Entity Type | Individual
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Provider Name | OLUBUKOLA ABAKE OLUSANYA
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Gender | Female
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 12/21/2012
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Provider Practice Location Address
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Address Line | 9800 CENTRE PKWY SUITE 655
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City | HOUSTON
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State | TX
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Zip | 77036-8271
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Country | US
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Telephone | 713-589-5289
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Fax | 713-995-1806
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Provider Business Mailing Address
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Address Line | 9800 CENTRE PKWY SUITE 655
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City | HOUSTON
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State | TX
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Zip | 77036-8271
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Country | US
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Telephone | 713-589-5289
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Fax | 713-995-1806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 011283
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License Number State | TX
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