Provider Demographics
NPI:1083930085
Name:OLUKOYA, PIUS O
Entity type:Individual
Prefix:
First Name:PIUS
Middle Name:O
Last Name:OLUKOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 NEW VALLEY HI
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-5678
Mailing Address - Country:US
Mailing Address - Phone:210-673-0817
Mailing Address - Fax:
Practice Address - Street 1:502 NEW VALLEY HI DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4394
Practice Address - Country:US
Practice Address - Phone:210-673-0817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX396201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy