Provider Demographics
NPI:1669731816
Name:FALEBITA, OLUWATOYIN TOLANI (MD)
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:TOLANI
Last Name:FALEBITA
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 1:404 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-3818
Mailing Address - Country:US
Mailing Address - Phone:240-481-5535
Mailing Address - Fax:
Practice Address - Street 1:2139 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20001
Practice Address - Country:US
Practice Address - Phone:202-865-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ5648261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program