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General NPI Number Information
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NPI Number | 1124633979
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Entity Type | Individual
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Provider Name | OMOLOLA OLUBUKOLA AREOLA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 18880 MARSH LN APT 506
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City | DALLAS
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State | TX
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Zip | 75287-2211
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Country | US
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Telephone | 972-267-3578
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 S.HWY 75
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City | SHERMAN
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State | TX
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Zip | 75090
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Country | US
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Telephone | 866-856-5923
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1006623
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License Number State | TX
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