Provider Demographics
NPI:1043639891
Name:OGUNMOKUN, ADE (APN)
Entity Type:Individual
Prefix:
First Name:ADE
Middle Name:
Last Name:OGUNMOKUN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GESSNER RD STE 280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3898
Mailing Address - Country:US
Mailing Address - Phone:713-468-6538
Mailing Address - Fax:713-468-1042
Practice Address - Street 1:2600 GESSNER RD STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3898
Practice Address - Country:US
Practice Address - Phone:713-468-6538
Practice Address - Fax:713-468-1042
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733211163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health