Provider Demographics
NPI:1235562448
Name:OLATOTO, MUSILIU O (MD, LSA)
Entity Type:Individual
Prefix:DR
First Name:MUSILIU
Middle Name:O
Last Name:OLATOTO
Suffix:
Gender:M
Credentials:MD, LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 W AIRPORT BLVD
Mailing Address - Street 2:UNIT 402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5224
Mailing Address - Country:US
Mailing Address - Phone:832-279-6465
Mailing Address - Fax:
Practice Address - Street 1:6633 W AIRPORT BLVD
Practice Address - Street 2:UNIT 402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5224
Practice Address - Country:US
Practice Address - Phone:832-279-6465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00449363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical