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Individual

AYORINDE OLATOKUNBO OGUNBAMERU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1301 SOLANA BLVD STE 2200, ROANOKE, TX 76262-1769
(817) 693-5486
(817) 717-6569
Mailing address
1301 SOLANA BLVD STE 2200, ROANOKE, TX 76262-1769
(817) 693-5486
(817) 717-6569

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T1500
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003147778A
GA
Enumeration date
07/06/2011
Last updated
10/13/2022
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