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General NPI Number Information
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NPI Number | 1194767442
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Entity Type | Individual
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Provider Name | MRS. ADESHOLA AJOKE OYENUGA
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Gender | Female
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 811 S CENTRAL EXPY SUITE 536
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City | RICHARDSON
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State | TX
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Zip | 75080-7415
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Country | US
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Telephone | 972-235-8383
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Fax | 972-235-8384
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Provider Business Mailing Address
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Address Line | 811 S CENTRAL EXPY SUITE 536
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City | RICHARDSON
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State | TX
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Zip | 75080-7415
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Country | US
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Telephone | 972-235-8383
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Fax | 972-235-8384
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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 | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 0083557
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License Number State | TX
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