Provider Demographics
NPI:1124633979
Name:AREOLA, OMOLOLA OLUBUKOLA
Entity type:Individual
Prefix:
First Name:OMOLOLA
Middle Name:OLUBUKOLA
Last Name:AREOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 S.HWY 75
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090
Mailing Address - Country:US
Mailing Address - Phone:866-856-5923
Mailing Address - Fax:
Practice Address - Street 1:18880 MARSH LN APT 506
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-2211
Practice Address - Country:US
Practice Address - Phone:972-267-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1006623163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse