Provider Demographics
NPI:1932642410
Name:OGEDENGBE, PATRICK A (MD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:A
Last Name:OGEDENGBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5902 LARAMIE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1718
Mailing Address - Country:US
Mailing Address - Phone:832-934-4943
Mailing Address - Fax:
Practice Address - Street 1:5902 LARAMIE RIVER CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-1718
Practice Address - Country:US
Practice Address - Phone:832-934-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)