Provider Demographics
NPI:1407453970
Name:OLATERU-OLAGBEGI, DOMIKAH (APRN-PMHNP)
Entity Type:Individual
Prefix:
First Name:DOMIKAH
Middle Name:
Last Name:OLATERU-OLAGBEGI
Suffix:
Gender:F
Credentials:APRN-PMHNP
Other - Prefix:
Other - First Name:DOMIKAH
Other - Middle Name:
Other - Last Name:BURKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 TWIN KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1774 W MCDERMOTT DR STE 150
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3424
Practice Address - Country:US
Practice Address - Phone:469-340-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016230363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health