Provider Demographics
NPI:1609388164
Name:HOPE EMERGENCY ROOM PLLC
Entity Type:Organization
Organization Name:HOPE EMERGENCY ROOM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUFEMI
Authorized Official - Middle Name:T
Authorized Official - Last Name:OLADELE-AJOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-899-7243
Mailing Address - Street 1:2111 E DENMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6243
Mailing Address - Country:US
Mailing Address - Phone:319-850-0874
Mailing Address - Fax:936-899-7245
Practice Address - Street 1:2111 E DENMAN AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6243
Practice Address - Country:US
Practice Address - Phone:936-899-7243
Practice Address - Fax:936-899-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160339261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care