Provider Demographics
NPI:1275133498
Name:OLADAPO, TOSAN O
Entity Type:Individual
Prefix:
First Name:TOSAN
Middle Name:O
Last Name:OLADAPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N TOWN EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4743
Mailing Address - Country:US
Mailing Address - Phone:972-613-7950
Mailing Address - Fax:972-682-4599
Practice Address - Street 1:915 N TOWN EAST BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4743
Practice Address - Country:US
Practice Address - Phone:972-613-7950
Practice Address - Fax:972-682-4599
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist