Provider Demographics
NPI:1598932410
Name:ADERINBOYE, OMOLARA VIOLET (MD)
Entity Type:Individual
Prefix:
First Name:OMOLARA
Middle Name:VIOLET
Last Name:ADERINBOYE
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 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:2601 DIMMITT RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1833
Practice Address - Country:US
Practice Address - Phone:806-296-5531
Practice Address - Fax:806-291-5688
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2521322080P0208X
TXN42332080P0208X, 208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist