Individual
DR. OPEOLUWA DANIYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2302 LONE STAR RD STE 220, MANSFIELD, TX 76063-8752
(682) 341-7220
(682) 341-7222
Mailing address
PO BOX 6278, FORT WORTH, TX 76115-0278
(817) 806-1140
(817) 806-1141
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
S5351
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1D9463
MEDICARE
TX
05
—
414484201
—
TX
Enumeration date
04/09/2015
Last updated
04/26/2021
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