Provider Demographics
NPI:1689869554
Name:AJAYI, LAWRENCE OLADAPO (PT)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:OLADAPO
Last Name:AJAYI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 CROSS TIMBERS RD
Mailing Address - Street 2:BLDG. 3 STE.100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2902
Mailing Address - Country:US
Mailing Address - Phone:972-539-5300
Mailing Address - Fax:972-539-5310
Practice Address - Street 1:3201 CROSS TIMBERS RD
Practice Address - Street 2:BLDG. 3 STE.100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2902
Practice Address - Country:US
Practice Address - Phone:972-539-5300
Practice Address - Fax:972-539-5310
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1085561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist