Provider Demographics
NPI:1326816455
Name:ORUNJA, TINA LLOUISE (OWNER)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:LLOUISE
Last Name:ORUNJA
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:ORUNJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT,CMA
Mailing Address - Street 1:11821 EAST FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1960
Mailing Address - Country:US
Mailing Address - Phone:832-871-0420
Mailing Address - Fax:
Practice Address - Street 1:11821 EAST FWY STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1960
Practice Address - Country:US
Practice Address - Phone:832-871-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy