=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780125559
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AYO BIOMETRICS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2017
-----------------------------------------------------
Last Update Date | 03/13/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5936 BROOKHAVEN DR
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-7862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-901-3369
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5936 BROOKHAVEN DR
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-7862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-901-3369
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING PARTNER
-----------------------------------------------------
Name | MR. OLATUNBOSUN OLUSEGUN OSUKOYA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-901-3369
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335V00000X
-----------------------------------------------------
Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------