Individual
ADEBOLA OMOTAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-1475
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
33996
OK
208000000X
Pediatrics Physician
35.143518
OH
208000000X
Pediatrics Physician
T4240
TX
208M00000X
Hospitalist Physician
Primary
T4240
TX
Other
Enumeration date
06/04/2018
Last updated
02/26/2025
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