Healthcare Provider Details

I. General information

NPI: 1679587000
Provider Name (Legal Business Name): OREOLUWA OGUNJI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S LANCASTER RD
DALLAS TX
75216-7167
US

IV. Provider business mailing address

4500 S LANCASTER RD
DALLAS TX
75216-7167
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-0751
  • Fax:
Mailing address:
  • Phone: 214-857-0751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberBO9267748
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberBO9267748
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: