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Individual

ISLAMIA A OMOOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 875-7176
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-1762

Taxonomy

Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
954527
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
954527
REGISTERD NURSE
TX
Enumeration date
01/04/2019
Last updated
01/04/2019
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