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General NPI Number Information
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NPI Number | 1942929583
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Entity Type | Individual
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Provider Name | ESTHER IDUNNU OLUGBUSI
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Gender | Female
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2901 RILEY FUZZEL RD
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City | SPRING
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State | TX
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Zip | 77386-4489
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Country | US
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Telephone | 832-823-7086
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Fax | 832-823-7315
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Provider Business Mailing Address
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Address Line | 8903 ROLLICK DR
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City | TOMBALL
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State | TX
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Zip | 77375-8005
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Country | US
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Telephone | 401-301-7968
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 40415
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License Number State | TX
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