Provider Demographics
NPI:1952623126
Name:OGUNLEYE, RACHAEL O
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:O
Last Name:OGUNLEYE
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 1:1400 CANDISE CT
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5511
Mailing Address - Country:US
Mailing Address - Phone:214-783-3992
Mailing Address - Fax:866-728-5785
Practice Address - Street 1:1400 CANDISE CT
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5511
Practice Address - Country:US
Practice Address - Phone:214-783-3992
Practice Address - Fax:866-728-5785
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management