Provider Demographics
NPI:1811179013
Name:BABAJIDE OGUNLANA, DPM, PLLC
Entity type:Organization
Organization Name:BABAJIDE OGUNLANA, DPM, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAJIDE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OGUNLANA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-778-5560
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 STE 1403
Practice Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX468365OtherMEDICARE
TX556250OtherMEDICARE