MEDICARE: OLUWAKEMI ESTHER OKUNLOLA

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1064690	TX

General Provider Information

NPI Number	:	1700760451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAKEMI ESTHER OKUNLOLA

Provider Business Mailing Address
First Line	:	4201 W PARMER LN STE C175
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4161
Country	:	US
Telephone Number	:	855-204-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 W PARMER LN BLDG C
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4109
Country	:	US
Telephone Number	:	855-204-2502
Fax Number	:

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

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	03/26/2026

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