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General NPI Number Information
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NPI Number | 1437808763
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Entity Type | Individual
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Provider Name | OLUWATOMI AJIBOLA MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 600 N BELL BLVD STE 100
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City | CEDAR PARK
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State | TX
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Zip | 78613-2216
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Country | US
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Telephone | 737-321-0200
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Fax | 737-321-0201
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Provider Business Mailing Address
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Address Line | 600 N BELL BLVD STE 100
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City | CEDAR PARK
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State | TX
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Zip | 78613-2216
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Country | US
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Telephone | 737-321-0200
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Fax | 737-321-0201
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT224883
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD491542
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License Number State | PA
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