Healthcare Provider Details

I. General information

NPI: 1427860659
Provider Name (Legal Business Name): OLUFUNKE VERONICA LEMBOYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 CITATION DR
ARLINGTON TX
76017-4530
US

IV. Provider business mailing address

2106 CITATION DR
ARLINGTON TX
76017-4530
US

V. Phone/Fax

Practice location:
  • Phone: 817-689-8438
  • Fax: 682-351-7514
Mailing address:
  • Phone: 817-689-8384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1183100
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAG11240101
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: