Provider Demographics
NPI:1447730940
Name:O'BANION, OLUFUNKE (RN)
Entity type:Individual
Prefix:
First Name:OLUFUNKE
Middle Name:
Last Name:O'BANION
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:OLUFUNKE
Other - Middle Name:
Other - Last Name:OKUSAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4611 HARDWOOD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-9595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 SOUTH TEXAS 6
Practice Address - Street 2:SUITE 311
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077
Practice Address - Country:US
Practice Address - Phone:713-575-2000
Practice Address - Fax:713-575-2031
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX917995163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse