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NPI Code Detail

MEDICARE: ENIOLA OGUNDE M.S., BCBA

MEDICARE: ENIOLA OGUNDE M.S., BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-24-73691TX
2106S00000XBehavior TechnicianRBT-21-194779TX

General Provider Information

NPI Number : 1275284325
Entity Type Code : Individual
Provider Name (Legal Business Name) : ENIOLA OGUNDE M.S., BCBA
Provider Business Mailing Address
First Line : 1012 GREENWAY GLEN DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-6541
Country : US
Telephone Number : 817-715-4709
Fax Number :
Provider Business Practice Location Address
First Line : 320 DECKER DRIVE
Second Line :
City : IRVING
State : TX
Zip : 75062-3999
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2022
Last Update Date : 04/09/2026

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