Provider Demographics
NPI:1447602834
Name:ODUMUSI, ARINOLA (MD)
Entity Type:Individual
Prefix:
First Name:ARINOLA
Middle Name:
Last Name:ODUMUSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 S PRESTON RD STE 1120
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1913
Mailing Address - Country:US
Mailing Address - Phone:469-481-6660
Mailing Address - Fax:
Practice Address - Street 1:291 S PRESTON RD STE 1120
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-1913
Practice Address - Country:US
Practice Address - Phone:469-481-6660
Practice Address - Fax:469-481-6561
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4568207R00000X
TXBP10057741390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program