Provider Demographics
NPI:1134417736
Name:ONAWUNMI, GBONJUBOLA OLUWATOYIN (MD)
Entity type:Individual
Prefix:
First Name:GBONJUBOLA
Middle Name:OLUWATOYIN
Last Name:ONAWUNMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GBONJUBOLA
Other - Middle Name:OLUWATOYIN
Other - Last Name:OYEFESO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 W MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7657
Mailing Address - Country:US
Mailing Address - Phone:817-702-2450
Mailing Address - Fax:817-702-8445
Practice Address - Street 1:1400 S MAIN ST STE 501
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4909
Practice Address - Country:US
Practice Address - Phone:817-702-3982
Practice Address - Fax:817-927-3982
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP9237207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine