Individual
OLAKUNLE ILUYOMADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 ELM ST STE 100, LEWISVILLE, TX 75057-3764
(214) 222-3571
(214) 744-5131
Mailing address
475 ELM ST STE 100, LEWISVILLE, TX 75057-3764
(214) 222-3571
(214) 744-5131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M7288
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M7288
TX
207RP1001X
Pulmonary Disease Physician
Primary
M7288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1882896-03
—
TX
01
—
P00788798
RR MEDICARE
TX
Enumeration date
09/11/2006
Last updated
08/21/2024
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