Healthcare Provider Details

I. General information

NPI: 1992570436
Provider Name (Legal Business Name): XPRESSDOC DFW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 09/16/2026
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 TEASLEY LN
DENTON TX
76205
US

IV. Provider business mailing address

5473 BLAIR ROAD SUITE 100, PMB 912463
DALLAS TX
75231-4101
US

V. Phone/Fax

Practice location:
  • Phone: 214-813-9632
  • Fax: 817-508-6693
Mailing address:
  • Phone: 773-742-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. OLUSOLA BALOGUN
Title or Position: OWNER
Credential: MD
Phone: 214-813-9632