Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1144545435 |
---|---|
Provider Name | Dr. Israeldivine Ola Kuyinu |
First Address | Houston, TX 77083-5817 |
Second Address | Houston, TX 77074-1611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 10/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12116713 | CAQH (01) | TX |
288027002 | (05) | TX |