MEDICARE: MISS OLANIKE AGBALE NP

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	363LF0000X	Family Nurse Practitioner	AP128407	TX

General Provider Information

NPI Number	:	1972924322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS OLANIKE AGBALE NP

Provider Business Mailing Address
First Line	:	7203 FIESTA FLOWER
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-0129
Country	:	US
Telephone Number	:	302-588-4635
Fax Number	:

Provider Business Practice Location Address
First Line	:	7203 FIESTA FLOWER
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-0129
Country	:	US
Telephone Number	:	302-588-4635
Fax Number	:

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

Provider Enumeration Date	:	01/01/2014
Last Update Date	:	09/22/2022

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Directions to “ MISS OLANIKE AGBALE NP” Practice Location

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