Bolanle Shalujo, RN
Individual provider Active NPI Registered Nurse · Beasley, TX
NPI 1497593628 · NPPES record last updated Jul 20, 2024
Key facts
- NPI
- 1497593628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN76494 (RI)
- Practice address
- 10947 Silver Canoe Dr
Beasley, TX 77417-0294 - Phone
- (346) 758-0232
- NPI assigned
- Jul 20, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN76494 | RI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Assurance LLC | Current |
Accepting new patients |
Locations
17350 State Highway 249
Ste 220
Houston, TX 77064
Phone (817) 386-9498
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN76494 | RI | Yes |
Addresses
Primary practice location
10947 Silver Canoe Dr
Beasley, TX 77417-0294
Mailing address
17350 State Highway 249 Ste 220
Houston, TX 77064-1132
Phone (346) 758-0232
Other providers in Beasley, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.