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Contact Information

THEOPHILUS T OGUNGBAMIGBE, MD
1302 BANKSTON LN
MANSFIELD, TX76063-8676
 Phone: 785-354-9591
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for THEOPHILUS T OGUNGBAMIGBE · (Male)

NPI Number 1043231228
Status Active
Credentials MD
Entity Individual
Enumeration date 07/22/2006
Last updated 05/06/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 04-32614
  • TX License # Q0140
  • KS Medicaid 200438400A
  • KS Other 106587 MEDICARE PTAN
  • KS Other P00426465 RAILROAD MEDICARE
  • NY Other 230637 LICENSE
Hospital affiliation(s)
  • CRESCENT MEDICAL CENTER LANCASTER - (Acute Care)
    2600 WEST PLEASANT RUN ROAD
    LANCASTER, TX 75146
  • METHODIST CHARLTON MEDICAL CENTER - (Acute Care)
    3500 W WHEATLAND ROAD
    DALLAS, TX 75237
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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