Individual
DR. ISRAELDIVINE OLA KUYINU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MHS, PA-C
Contact information
Practice address
8130 MORNING ROSE LN, HOUSTON, TX 77095-4954
(346) 624-7207
Mailing address
8130 MORNING ROSE LN, HOUSTON, TX 77095-4954
(281) 830-2533
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
—
—
175L00000X
Homeopath
—
—
363A00000X
Physician Assistant
Primary
PA06693
TX
363AM0700X
Medical Physician Assistant
PA06693
TX
363AS0400X
Surgical Physician Assistant
PA06693
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12116713
CAQH
TX
05
—
288027002
—
TX
Enumeration date
03/30/2010
Last updated
04/20/2024
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