Individual
DR. AGBOLADE O. ODUTAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
300 W 4TH ST, CAMERON, TX 76520-2509
(254) 697-3100
(254) 697-3112
Mailing address
300 W 4TH ST, CAMERON, TX 76520-2509
(254) 697-3100
(254) 697-3112
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K6196
TX
207Q00000X
Family Medicine Physician
K6196
TX
207R00000X
Internal Medicine Physician
K6196
TX
Other
Enumeration date
05/24/2006
Last updated
01/29/2024
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