Provider Demographics
NPI:1669546024
Name:OGUNLANA, MONSUART A (DO)
Entity type:Individual
Prefix:MRS
First Name:MONSUART
Middle Name:A
Last Name:OGUNLANA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MR
Other - First Name:MANSUR
Other - Middle Name:KOLA
Other - Last Name:OGUNLANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15706 ROSEWOOD HILL CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-7168
Mailing Address - Country:US
Mailing Address - Phone:281-568-9055
Mailing Address - Fax:
Practice Address - Street 1:2000 CRAWFORD ST STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9000
Practice Address - Country:US
Practice Address - Phone:713-658-1000
Practice Address - Fax:713-658-1004
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009486251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677870Medicare ID - Type Unspecified