MEDICARE: ALPHA PULMONARY CONSULTANTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician
2	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1043517048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA PULMONARY CONSULTANTS

Provider Business Mailing Address
First Line	:	508 S ADAMS ST STE 218
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2151
Country	:	US
Telephone Number	:	817-624-3063
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 W EXCHANGE AVE STE 301
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76164-9614
Country	:	US
Telephone Number	:	817-624-3063
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. OYEYEMI A FABUYI
Credential	:	M.D.
Telephone Number	:	817-624-3063

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	02/28/2011

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Directions to “ALPHA PULMONARY CONSULTANTS ” Practice Location

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