Individual
DR. OLABAMIJI KAZEEM ABIMBOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DSC, PA-C
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(401) 365-0464
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(401) 365-0464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA6600
MA
363AM0700X
Medical Physician Assistant
Primary
PA13372
TX
363AS0400X
Surgical Physician Assistant
PA6600
MA
Other
Enumeration date
06/12/2018
Last updated
12/21/2021
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