Provider Demographics
NPI:1740786672
Name:OSO, TOLULOPE IBUKUN (MD)
Entity Type:Individual
Prefix:
First Name:TOLULOPE
Middle Name:IBUKUN
Last Name:OSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TOLULOPE
Other - Middle Name:IBUKUN
Other - Last Name:TENIOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN ST STE 5.020
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6223
Mailing Address - Fax:713-500-6270
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7160
Practice Address - Fax:713-500-0648
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXU1734207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program