OLADELE OLUSANYA MD PA NPI 1417078411

NPI Information

OLADELE OLUSANYA MD PA is a family medicine in Dallas, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OLADELE OLUSANYA MD PA NPI is 1417078411. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8067 WEST VIRGINIA DR
DALLAS, TX
ZIP 75237-767
Phone: (972) 230-5601
Fax: (972) 230-5591

The provider's authorized official is Oladele O Olusanya .
The authorized official title is President and has the following contact phone number (972) 230-5601.

The CLIA number assigned to this NPI record is 45D1001771 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 6/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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