Provider Demographics
NPI:1982227252
Name:OSUNDE, MAGDALENE (NP)
Entity Type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:
Last Name:OSUNDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5457
Mailing Address - Country:US
Mailing Address - Phone:469-826-8541
Mailing Address - Fax:866-497-1972
Practice Address - Street 1:1269 LONGLEAF DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5457
Practice Address - Country:US
Practice Address - Phone:214-476-3770
Practice Address - Fax:866-497-1972
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144921363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health