Provider Demographics
NPI:1679040653
Name:OLOWO, BAMIKOLE (APRN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:BAMIKOLE
Middle Name:
Last Name:OLOWO
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:MR
Other - First Name:BANKY
Other - Middle Name:
Other - Last Name:OLOWO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3005 SAN MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-3757
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10009 N MACARTHUR BLVD STE 109
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5082
Practice Address - Country:US
Practice Address - Phone:214-812-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138022207R00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine