Provider Demographics
NPI:1891716460
Name:ABEBEFE, DAVID OLATUNJI (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OLATUNJI
Last Name:ABEBEFE
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 1:5065 ROYAL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4069
Mailing Address - Country:US
Mailing Address - Phone:214-402-0685
Mailing Address - Fax:
Practice Address - Street 1:1900 S D ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1507
Practice Address - Country:US
Practice Address - Phone:956-994-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049491207R00000X
TXJ9940207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U52NOtherBCBS
TX139385226Medicaid
TX613109Medicare PIN
VAF74317Medicare UPIN