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NPI Code Detail

MEDICARE: DR. OSARETIN CHARLES AIMUYO MD

MEDICARE: DR. OSARETIN CHARLES AIMUYO MD
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
1208000000XPediatrics Physician00000LA
2208000000XPediatrics PhysicianT8161TX

General Provider Information

NPI Number : 1699267666
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OSARETIN CHARLES AIMUYO MD
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-6483
Fax Number : 682-885-3113
Provider Business Practice Location Address
First Line : 3131 S CENTER ST
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2007
Country : US
Telephone Number : 817-375-1413
Fax Number : 817-375-9101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2018
Last Update Date : 09/21/2022

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