OLADELE OLUSANYA MD PA NPI 1417078411

NPI Information

  • NPI: 1417078411
  • Provider Name: OLADELE OLUSANYA MD PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 45D1001771
  • Address: 8067 WEST VIRGINIA DR
    DALLAS, TX
    ZIP 75237
  • Phone: (972) 230-5601

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NPI Details

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineK8398TEXASYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100867TMEDICARE ID-TYPE UNSPECIFIEDTEXAS
2153097402OTHERTEXASMEDICAID THSTEPS
3G63526MEDICARE UPIN
4153097401MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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