Provider Demographics
NPI:1922439389
Name:FOLAHAN AYOOLA MD PA
Entity Type:Organization
Organization Name:FOLAHAN AYOOLA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FOLAHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:AYOOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-382-9429
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:940-382-9429
Mailing Address - Fax:940-387-2426
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:940-387-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2826208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB160831Medicare UPIN