Provider Demographics
NPI:1811532153
Name:SANNI, OLUWAKEMI
Entity type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:
Last Name:SANNI
Suffix:
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 1:2250 ELDRIDGE PKWY APT 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1861
Mailing Address - Country:US
Mailing Address - Phone:713-584-7829
Mailing Address - Fax:
Practice Address - Street 1:2250 ELDRIDGE PKWY APT 635
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1861
Practice Address - Country:US
Practice Address - Phone:713-584-7829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle