Provider Demographics
NPI:1336430818
Name:OYENIYI, GLORIA (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:OYENIYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N COIT RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6656
Mailing Address - Country:US
Mailing Address - Phone:512-222-6419
Mailing Address - Fax:888-815-3583
Practice Address - Street 1:1400 N COIT RD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6655
Practice Address - Country:US
Practice Address - Phone:512-222-6419
Practice Address - Fax:888-815-3583
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP99292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352076901Medicaid
TX430834YRLZMedicare PIN