Individual
AGBOOLA O FATIREGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3501 N MACARTHUR BLVD STE 450, IRVING, TX 75062-3651
(972) 786-0330
(972) 739-2894
Mailing address
3501 N MACARTHUR BLVD STE 500, IRVING, TX 75062-3675
(972) 256-3700
(866) 630-6348
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
220389
NY
208000000X
Pediatrics Physician
Primary
M7173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189208501
—
TX
01
—
8W4546
BLUE CROSS
TX
Enumeration date
07/20/2005
Last updated
10/16/2020
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