Individual
THEOPHILUS O OLUMESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3506 21ST ST, SUITE 605, LUBBOCK, TX 79410-1212
(806) 725-4130
(806) 723-7137
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
P3948
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2011
Last updated
09/04/2012
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