Provider Demographics
NPI:1851500201
Name:AYOOLA, FOLAHAN (MD)
Entity Type:Individual
Prefix:
First Name:FOLAHAN
Middle Name:
Last Name:AYOOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6817
Mailing Address - Country:US
Mailing Address - Phone:214-336-4071
Mailing Address - Fax:
Practice Address - Street 1:3321 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6817
Practice Address - Country:US
Practice Address - Phone:940-382-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018689390200000X
TXP2826208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program