Provider Demographics
NPI:1487079299
Name:LAWAL, SAUSAN (DO)
Entity type:Individual
Prefix:DR
First Name:SAUSAN
Middle Name:
Last Name:LAWAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 PINECROFT DR STE 350
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3280
Mailing Address - Country:US
Mailing Address - Phone:346-320-5200
Mailing Address - Fax:
Practice Address - Street 1:9200 PINECROFT DR STE 350
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3280
Practice Address - Country:US
Practice Address - Phone:346-320-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHR3366207V00000X
390200000X
TXR3366207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program