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General NPI Number Information
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NPI Number | 1356536627
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Entity Type | Organization
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Legal Business Name | FUNMILAYO OLADUN
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 7125 MARVIN D LOVE FWY SUITE 302
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City | DALLAS
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State | TX
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Zip | 75237-3175
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Country | US
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Telephone | 972-709-0808
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Fax | 972-709-7244
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Provider Business Mailing Address
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Address Line | 7125 MARVIN D LOVE FWY SUITE 302
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City | DALLAS
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State | TX
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Zip | 75237-3175
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Country | US
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Telephone | 972-709-0808
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Fax | 972-709-7244
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. FUNMI OLADUN
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Credential |
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Telephone | 972-709-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 32012163203
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License Number State | TX
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