Provider Demographics
NPI:1134150675
Name:SMITH, OLUWATOSIN UROWOLI (MD)
Entity type:Individual
Prefix:DR
First Name:OLUWATOSIN
Middle Name:UROWOLI
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 W SPRING CREEK PKWY
Mailing Address - Street 2:STE 110
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3569
Mailing Address - Country:US
Mailing Address - Phone:214-360-0000
Mailing Address - Fax:214-360-0083
Practice Address - Street 1:10740 N CENTRAL EXPY
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2161
Practice Address - Country:US
Practice Address - Phone:214-360-0000
Practice Address - Fax:214-360-0083
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18355207W00000X
TXN2814207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00462324OtherRAILROAD MEDICARE
MS09450860Medicaid
MSP00208857OtherRAILROAD MEDICARE
MS180000319Medicare ID - Type Unspecified
MSP00462324OtherRAILROAD MEDICARE
MSH76293Medicare UPIN