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General NPI Number Information
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NPI Number | 1356901581
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Entity Type | Individual
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Provider Name | ADEBUKOLA OBASANYA
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 307 S MCDONALD ST STE 500
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City | MCKINNEY
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State | TX
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Zip | 75069-5625
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Country | US
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Telephone | 469-202-7572
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Fax | 469-329-1044
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Provider Business Mailing Address
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Address Line | 688 W PIONEER PKWY STE 120
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City | GRAND PRAIRIE
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State | TX
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Zip | 75051-4861
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Country | US
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Telephone | 972-642-7337
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP140289
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License Number State | TX
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