Provider Demographics
NPI:1841706033
Name:OLUBUNMI, PETERS OLADOTUN
Entity type:Individual
Prefix:MR
First Name:PETERS
Middle Name:OLADOTUN
Last Name:OLUBUNMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 GREEN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-2403
Mailing Address - Country:US
Mailing Address - Phone:214-554-5858
Mailing Address - Fax:
Practice Address - Street 1:12705 GREEN RIVER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-2403
Practice Address - Country:US
Practice Address - Phone:214-554-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other