Provider Demographics
NPI:1104320514
Name:WEMIMO, OYINDAMOLA OJUOLAPE (MD)
Entity type:Individual
Prefix:
First Name:OYINDAMOLA
Middle Name:OJUOLAPE
Last Name:WEMIMO
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 1:1218 W MCDERMOTT DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6304
Mailing Address - Country:US
Mailing Address - Phone:972-390-9000
Mailing Address - Fax:
Practice Address - Street 1:1218 W MCDERMOTT DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6304
Practice Address - Country:US
Practice Address - Phone:972-390-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD049291207Q00000X
TXT3843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine