Organization
CY-SAGE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHADIJAT OGUNBIYI M.D. (OWNER/PRESIDENT)
(832) 368-0596
Entity
Organization
Contact information
Practice address
16506 FM 529 RD STE 116, HOUSTON, TX 77095
(281) 815-3812
(281) 815-3812
Mailing address
PO BOX 1239, CYPRESS, TX 77410-1239
(281) 815-3812
(833) 217-0891
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200613040A
—
TX
Enumeration date
04/26/2017
Last updated
08/09/2022
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