MEDICARE: DR. OYEYEMI ADETOKUNBO FABUYI M.D.

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	207R00000X	Internal Medicine Physician	L9188	TX
2	207RP1001X	Pulmonary Disease Physician	L9188	TX
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	L9188	TX
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	L9188	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00991901	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407826498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OYEYEMI ADETOKUNBO FABUYI M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-378-3699

Provider Business Practice Location Address
First Line	:	508 SOUTH ADAMS STREET, SUITE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2151
Country	:	US
Telephone Number	:	817-332-7600
Fax Number	:	817-332-7606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	08/27/2019

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Directions to “ DR. OYEYEMI ADETOKUNBO FABUYI M.D.” Practice Location

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