Provider Demographics
NPI:1699275073
Name:ALONGE, OLUWATOSIN VICTORIA
Entity type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:VICTORIA
Last Name:ALONGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20723 BARRINGTON MEADOW TRCE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2268
Mailing Address - Country:US
Mailing Address - Phone:937-312-5835
Mailing Address - Fax:
Practice Address - Street 1:14911 SUGAR FALLS CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4070
Practice Address - Country:US
Practice Address - Phone:937-312-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136555363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care