Individual
FIDELIA OLABODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 W SEMANDS ST, CONROE, TX 77301-1867
(781) 486-4116
Mailing address
12710 BRANT ROCK DR APT 1105, HOUSTON, TX 77082-5433
(832) 279-3568
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
960266
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0301
MINE
—
Enumeration date
03/20/2019
Last updated
06/11/2019
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