Healthcare Provider Details

I. General information

NPI: 1275930422
Provider Name (Legal Business Name): OLUBUKOLA T ADEYEYE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLUBUKOLA T AJISAFE M.D.

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8751 COLLIN MCKINNEY PKWY STE 1102
MCKINNEY TX
75070-1872
US

IV. Provider business mailing address

8751 COLLIN MCKINNEY PKWY STE 1102
MCKINNEY TX
75070-1872
US

V. Phone/Fax

Practice location:
  • Phone: 469-884-7233
  • Fax: 469-429-5369
Mailing address:
  • Phone: 469-884-7233
  • Fax: 469-429-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ8689
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: