Provider Demographics
NPI:1225510498
Name:OKUNROBO, ADESUWA N/A
Entity Type:Individual
Prefix:
First Name:ADESUWA
Middle Name:N/A
Last Name:OKUNROBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 TANGLEWILDE ST APT 505
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5159
Mailing Address - Country:US
Mailing Address - Phone:713-927-9758
Mailing Address - Fax:
Practice Address - Street 1:3780 TANGLEWILDE ST APT 505
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5159
Practice Address - Country:US
Practice Address - Phone:713-927-9758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344276164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse