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NPI Code Detail

MEDICARE: BABAJIDE OGUNLANA, DPM, PLLC

MEDICARE: BABAJIDE OGUNLANA, DPM, PLLC
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
1261QM2500XMedical Specialty Clinic/Center
2261QP1100XPodiatric Clinic/Center
3213E00000XPodiatrist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1468365OTHERTXMEDICARE

General Provider Information

NPI Number : 1811179013
Entity Type Code : Organization
Provider Name (Legal Business Name) : BABAJIDE OGUNLANA, DPM, PLLC
Provider Business Mailing Address
First Line : 4502 RIVERSTONE BLVD STE 1403
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-5206
Country : US
Telephone Number : 281-778-5560
Fax Number : 281-677-4145
Provider Business Practice Location Address
First Line : 4502 RIVERSTONE BLVD STE 1403
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-5206
Country : US
Telephone Number : 281-778-5560
Fax Number : 281-677-4145
Authorized Official
Title or Position : CEO
Name : DR. BABAJIDE A OGUNLANA
Credential : DPM
Telephone Number : 281-778-5560
Provider Enumeration Date : 11/29/2007
Last Update Date : 11/18/2024

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