Organization
DALLAS PULMONARY & SLEEP CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILUS OGUNGBAMIGBE M.D (SOLE MBR)
(917) 517-4069
Entity
Organization
Contact information
Practice address
1302 BANKSTON LN, MANSFIELD, TX 76063-8676
(917) 517-4069
Mailing address
1302 BANKSTON LN, MANSFIELD, TX 76063-8676
(917) 517-4069
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
05/14/2015
Last updated
05/06/2024
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