MEDICARE: ABIOLA OPABUNMI AGNP-PC

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	363LA2200X	Adult Health Nurse Practitioner	AP134852	TX

General Provider Information

NPI Number	:	1427205947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIOLA OPABUNMI AGNP-PC

Provider Business Mailing Address
First Line	:	8030 FM 1765 STE C-102
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-3689
Country	:	US
Telephone Number	:	409-515-3915
Fax Number	:

Provider Business Practice Location Address
First Line	:	8030 FM 1765 STE C-102
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591
Country	:	US
Telephone Number	:	409-515-3915
Fax Number	:	409-299-3773

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	10/24/2019

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