Provider Demographics
NPI:1912228800
Name:OGUNLEYE, OLUBUNMI TEMITOPE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUBUNMI
Middle Name:TEMITOPE
Last Name:OGUNLEYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 WAGNER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3719
Mailing Address - Country:US
Mailing Address - Phone:713-868-3301
Mailing Address - Fax:713-868-4817
Practice Address - Street 1:1234 WAGNER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3719
Practice Address - Country:US
Practice Address - Phone:713-868-3301
Practice Address - Fax:713-868-4817
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6545208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice