MEDICARE: BANKOLE FAMILY CLINIC, PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1780485425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANKOLE FAMILY CLINIC, PLLC

Provider Business Mailing Address
First Line	:	3201 TEASLEY LN BLDG 300
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-8302
Country	:	US
Telephone Number	:	940-239-3715
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 TEASLEY LN BLDG 300
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-8302
Country	:	US
Telephone Number	:	940-239-3715
Fax Number	:	361-355-8958

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	OLAWALE BANKOLE
Credential	:	NP
Telephone Number	:	940-239-3715

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	02/03/2026

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