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Organization
OLADELE OLUSANYA MD PA
Active
Organization
OLADELE OLUSANYA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLADELE O OLUSANYA MD (PRESIDENT)
(972) 230-5601
Entity
Organization
Contact information
Practice address
8067 WEST VIRGINIA DR, DALLAS, TX 75237-3767
(972) 230-5601
(972) 230-5591
Mailing address
8067 WEST VIRGINIA DR, DALLAS, TX 75237-3767
(972) 230-5601
(972) 230-5591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K8398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153097401
—
TX
01
—
153097402
MEDICAID THSTEPS
TX
Enumeration date
04/03/2007
Last updated
06/06/2012
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