Provider Demographics
NPI:1275783557
Name:OYERINDE, OLAWUNMI (PA-C)
Entity Type:Individual
Prefix:
First Name:OLAWUNMI
Middle Name:
Last Name:OYERINDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:OLAWUNMI
Other - Middle Name:
Other - Last Name:MAJEKODUNMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2300 MARIE CURIE DR
Mailing Address - Street 2:BALYOR MEDICAL CENTER- GARLAND
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 MARIE CURIE DR
Practice Address - Street 2:BAYLOR MEDICAL CENTER - GARLAND
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5706
Practice Address - Country:US
Practice Address - Phone:972-487-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005304363A00000X
IL085003602363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC37626075Medicare PIN