MEDICARE: CHRISTIANAH OGUNLEYE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	U9044	TX

General Provider Information

NPI Number	:	1174100531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIANAH OGUNLEYE MD

Provider Business Mailing Address
First Line	:	5505 W OREM DR STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77085-1277
Country	:	US
Telephone Number	:	713-283-1039
Fax Number	:

Provider Business Practice Location Address
First Line	:	5505 W OREM DR STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77085-1277
Country	:	US
Telephone Number	:	713-283-1039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	07/22/2024

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