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NPI Code Detail

MEDICARE: O. E. EZEKOYE, MD, PA

MEDICARE: O. E. EZEKOYE, MD, PA
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1205016672
Entity Type Code : Organization
Provider Name (Legal Business Name) : O. E. EZEKOYE, MD, PA
Provider Business Mailing Address
First Line : 1 CHISHOLM TRL
Second Line : SUITE 4100
City : ROUND ROCK
State : TX
Zip : 78681-5008
Country : US
Telephone Number : 512-388-9711
Fax Number :
Provider Business Practice Location Address
First Line : 1 CHISHOLM TRL
Second Line : SUITE 4100
City : ROUND ROCK
State : TX
Zip : 78681-5008
Country : US
Telephone Number : 512-388-9711
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. OLUFUNKE EZEKOYE
Credential :
Telephone Number : 512-388-9711
Provider Enumeration Date : 11/13/2007
Last Update Date : 11/13/2007

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Directions to “O. E. EZEKOYE, MD, PA ” Practice Location

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