Individual
BUKOLA DUROJAIYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 N BEECH ST, TYLER COUNTY HOSPITAL FAMILY MEDICAL CLINIC, WOODVILLE, TX 75979
(409) 283-2822
Mailing address
104 N BEECH ST, WOODVILLE, TX 75979-4718
(409) 283-2822
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP131313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP131313
APRN LICENSE #
TX
Enumeration date
08/19/2016
Last updated
11/17/2016
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