Provider Demographics
NPI:1821199464
Name:ABIODUN, OLUFEMI J (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUFEMI
Middle Name:J
Last Name:ABIODUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 HIGHLANDER BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1163
Mailing Address - Country:US
Mailing Address - Phone:817-468-7200
Mailing Address - Fax:817-468-7201
Practice Address - Street 1:301 HIGHLANDER BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1163
Practice Address - Country:US
Practice Address - Phone:817-468-7200
Practice Address - Fax:817-468-7201
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI46918207RG0100X
IL036168849207RG0100X
TXM2238207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI13283Medicare UPIN
TX8F33742Medicare PIN