Provider Demographics
NPI:1013531151
Name:OLADOKUN, OLUBUKOLA O SR
Entity Type:Individual
Prefix:
First Name:OLUBUKOLA
Middle Name:O
Last Name:OLADOKUN
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 GARDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7392
Mailing Address - Country:US
Mailing Address - Phone:832-275-0054
Mailing Address - Fax:
Practice Address - Street 1:4430 GARDEN RIDGE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7392
Practice Address - Country:US
Practice Address - Phone:832-275-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)