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General NPI Number Information
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NPI Number | 1972895522
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Entity Type | Organization
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Legal Business Name | MARY OLADUNNI BAIYERI M.D., P.A
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 1400 W NORTHWEST HWY STE 280
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City | GRAPEVINE
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State | TX
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Zip | 76051-8120
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Country | US
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Telephone | 817-416-8887
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Fax | 817-416-8878
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Provider Business Mailing Address
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Address Line | 1400 W NORTHWEST HWY STE 280
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City | GRAPEVINE
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State | TX
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Zip | 76051-8120
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Country | US
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Telephone | 817-416-8887
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Fax | 817-416-8878
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY BAIYERI
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Credential | M.D.
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Telephone | 817-416-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number |
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License Number State |
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