Healthcare Provider Details

I. General information

NPI: 1013229871
Provider Name (Legal Business Name): ESTHER OLUWAKEMI OGUNJIMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: E. OLUWAKEMI OGUNJIMI MD

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 4TH STREET MS 8340 DEPT OB/GYN
LUBBOCK TX
79430
US

IV. Provider business mailing address

3601 4TH STREET, MS 8340 DEPT OB/GYN
LUBBOCK TX
79430
US

V. Phone/Fax

Practice location:
  • Phone: 209-476-2080
  • Fax:
Mailing address:
  • Phone: 806-743-3112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR8957
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: