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1649026998
OLUSHOLA A. BALOGUN
GRAND PRAIRIE, TX
NPI
1649026998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX 1000117)
Enumeration Date
2024-04-27
Last Update Date
2024-09-06
Business Address
OLUSHOLA A. BALOGUN NP
811 W JEFFERSON ST
GRAND PRAIRIE, TX 75051-1645
Phone number: 214-662-2675
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Mailing Address
OLUSHOLA A. BALOGUN NP
811 W JEFFERSON ST
GRAND PRAIRIE, TX 75051-1645
Phone number: 214-662-2675
Copy
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