Provider Demographics
NPI:1790277374
Name:POPOOLA, TAIYE OLUYOMI (MD PHD)
Entity Type:Individual
Prefix:
First Name:TAIYE
Middle Name:OLUYOMI
Last Name:POPOOLA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CENTURY PKWY UNIT 2180
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8043
Mailing Address - Country:US
Mailing Address - Phone:972-521-6191
Mailing Address - Fax:972-252-7580
Practice Address - Street 1:450 CENTURY PKWY STE 250
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8136
Practice Address - Country:US
Practice Address - Phone:972-521-6191
Practice Address - Fax:972-252-7580
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210369102084P0800X
TXU43122084S0012X, 2084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine