Provider Demographics
NPI:1770659567
Name:SALAKO, OLUBUNMI NKEM (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUBUNMI
Middle Name:NKEM
Last Name:SALAKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6400 WINDCREST DR
Mailing Address - Street 2:APT #115
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3051
Mailing Address - Country:US
Mailing Address - Phone:972-655-9982
Mailing Address - Fax:
Practice Address - Street 1:2750 W NORTHWEST HWY
Practice Address - Street 2:SUITE 170
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4772
Practice Address - Country:US
Practice Address - Phone:214-654-0007
Practice Address - Fax:214-654-9272
Is Sole Proprietor?:No
Enumeration Date:2006-11-26
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108844208000000X
TXP5234208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics