Provider Demographics
NPI:1891793071
Name:OGUNLANA, BABAJIDE ADENIYI (DPM)
Entity Type:Individual
Prefix:DR
First Name:BABAJIDE
Middle Name:ADENIYI
Last Name:OGUNLANA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 RIVERSTONE BLVD STE 1403
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5206
Mailing Address - Country:US
Mailing Address - Phone:281-778-5560
Mailing Address - Fax:281-677-4145
Practice Address - Street 1:4502 RIVERSTONE BLVD
Practice Address - Street 2:STE 1403
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5206
Practice Address - Country:US
Practice Address - Phone:281-778-5560
Practice Address - Fax:281-677-4145
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1699213ES0131X, 213ES0103X, 213E00000X, 213ER0200X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0074MEOtherBLUE CROSS BLUE SHIELD
V00430Medicare UPIN
TX8F0009Medicare PIN
TX5462190001Medicare NSC