Individual
OSIYEMI O OSINOWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Mailing address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48247
KY
207RN0300X
Nephrology Physician
Primary
R7840
TX
208M00000X
Hospitalist Physician
48247
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387463801
—
TX
Enumeration date
06/22/2012
Last updated
01/28/2020
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