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General NPI Number Information
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NPI Number | 1568470045
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Entity Type | Individual
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Provider Name | MR. OLALEKAM ADIGUM SORUMKE
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 10935 ESTATE LANE STE.274
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 214-553-2544
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Fax | 214-503-0315
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Provider Business Mailing Address
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Address Line | 10935 ESTATE LN SUITE 274
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City | DALLAS
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State | TX
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Zip | 75238-2316
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Country | US
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Telephone | 214-553-2544
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Fax | 214-503-0315
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0089529
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License Number State | TX
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