MEDICARE: OLATEJU I ONILOGBO

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	1212973	TX

General Provider Information

NPI Number	:	1861363244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLATEJU I ONILOGBO

Provider Business Mailing Address
First Line	:	2150 S CENTRAL EXPY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-4070
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 S CENTRAL EXPY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-4070
Country	:	US
Telephone Number	:	682-305-7924
Fax Number	:

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

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	04/06/2026

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