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General NPI Number Information
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NPI Number | 1790277374
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Entity Type | Individual
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Provider Name | TAIYE OLUYOMI POPOOLA MD PHD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 450 CENTURY PKWY STE 250
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City | ALLEN
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State | TX
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Zip | 75013-8136
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Country | US
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Telephone | 972-521-6191
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Fax | 972-252-7580
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Provider Business Mailing Address
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Address Line | 401 CENTURY PKWY UNIT 2180
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City | ALLEN
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State | TX
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Zip | 75013-8043
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Country | US
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Telephone | 972-521-6191
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Fax | 972-252-7580
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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 | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | U4312
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2021036910
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | U4312
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License Number State | TX
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