Provider Demographics
NPI:1134729866
Name:OTULANA, BILQUIS OMOLOLA (PHARMD)
Entity type:Individual
Prefix:
First Name:BILQUIS
Middle Name:OMOLOLA
Last Name:OTULANA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BILQUIS
Other - Middle Name:OMOLOLA
Other - Last Name:ADENIYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13619 TEAL BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1307
Mailing Address - Country:US
Mailing Address - Phone:505-363-7882
Mailing Address - Fax:
Practice Address - Street 1:13619 TEAL BLUFF LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1307
Practice Address - Country:US
Practice Address - Phone:505-363-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist