Provider Demographics
NPI:1396826855
Name:LAYIWOLA, FEMI (MD)
Entity type:Individual
Prefix:
First Name:FEMI
Middle Name:
Last Name:LAYIWOLA
Suffix:
Gender:M
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:PO BOX 530654
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-0654
Mailing Address - Country:US
Mailing Address - Phone:956-465-0626
Mailing Address - Fax:877-346-1789
Practice Address - Street 1:4002 PAREDES LINE RD STE 26
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-1375
Practice Address - Country:US
Practice Address - Phone:956-465-0626
Practice Address - Fax:877-346-1789
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4268207R00000X
FLME94544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183882303Medicaid
TX8X1540OtherBCBS TX
TX183882301Medicaid
TX183882301Medicaid
TX8J0109Medicare PIN
TXI67056Medicare UPIN