Provider Demographics
NPI:1063121002
Name:OLASUNKANMI, ANU JOSEPH
Entity type:Individual
Prefix:
First Name:ANU
Middle Name:JOSEPH
Last Name:OLASUNKANMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 LA PUENTE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1127
Mailing Address - Country:US
Mailing Address - Phone:917-780-9406
Mailing Address - Fax:
Practice Address - Street 1:6730 LA PUENTE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1127
Practice Address - Country:US
Practice Address - Phone:917-780-9406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)