Individual
ELIZABETH EBUNOLUWA ILESANMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 CLOVER RANCH CIR, KATY, TX 77494-3015
(281) 857-9989
Mailing address
3111 CLOVER RANCH CIR, KATY, TX 77494-3015
(281) 857-9989
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
304815
TX
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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