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NPI Code Detail

MEDICARE: ADEOLA OGUNLANA AGPCNP-C

MEDICARE: ADEOLA OGUNLANA AGPCNP-C
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
1163W00000XRegistered Nurse791719TX
2363LA2200XAdult Health Nurse PractitionerAP133408TX
3363LP0808XPsychiatric/Mental Health Nurse Practitioner2023063370TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669913489
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADEOLA OGUNLANA AGPCNP-C
Provider Business Mailing Address
First Line : 11511 SHADOW CREEK PKWY
Second Line :
City : PEARLAND
State : TX
Zip : 77584-7298
Country : US
Telephone Number : 713-442-0000
Fax Number :
Provider Business Practice Location Address
First Line : 2515 BUSINESS CENTER DR
Second Line :
City : PEARLAND
State : TX
Zip : 77584-2294
Country : US
Telephone Number : 713-442-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2017
Last Update Date : 08/16/2023

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