Individual
LANESE OGUNKUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 645-2800
(214) 645-2808
Mailing address
UT SOUTHWESTERN BILLING, P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 645-0600
(214) 645-2762
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
817446
TX
Other
Enumeration date
08/27/2012
Last updated
05/21/2013
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