Provider Demographics
NPI:1073094595
Name:AFOLABI, FOLASHADE (LVN)
Entity Type:Individual
Prefix:
First Name:FOLASHADE
Middle Name:
Last Name:AFOLABI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19400 W BELLFORT ST APT 1230
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8204
Mailing Address - Country:US
Mailing Address - Phone:832-876-3175
Mailing Address - Fax:
Practice Address - Street 1:10101 FONDREN RD STE 428
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5133
Practice Address - Country:US
Practice Address - Phone:713-772-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340511164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse