Provider Demographics
NPI:1295327286
Name:OLANG, MILLICENT LUCY (AGACNP)
Entity type:Individual
Prefix:
First Name:MILLICENT
Middle Name:LUCY
Last Name:OLANG
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 GRAHAM DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3348
Mailing Address - Country:US
Mailing Address - Phone:281-351-6464
Mailing Address - Fax:281-351-6476
Practice Address - Street 1:506 GRAHAM DR STE 100
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3348
Practice Address - Country:US
Practice Address - Phone:281-351-6464
Practice Address - Fax:281-351-6476
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019568363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care