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General NPI Number Information
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NPI Number | 1033300074
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Entity Type | Individual
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Provider Name | OLUSEGUN ADEWOLE OYENUGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 3001 E PRESIDENT GEORGE BUSH HWY STE 175
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City | RICHARDSON
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State | TX
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Zip | 75082-3551
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Country | US
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Telephone | 972-941-3117
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Fax | 844-289-7691
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Provider Business Mailing Address
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Address Line | 3001 E PRESIDENT GEORGE BUSH HWY STE 175
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City | RICHARDSON
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State | TX
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Zip | 75082-3551
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Country | US
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Telephone | 972-941-3117
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Fax | 844-289-7691
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD437667
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036127256
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | Q5888
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License Number State | TX
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