Provider Demographics
NPI:1306660758
Name:OLED MEDICAL HOLDINGS LLC
Entity type:Organization
Organization Name:OLED MEDICAL HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:APRN,FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:OLEDIBE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:866-307-8454
Mailing Address - Street 1:12222 MERIT DR STE 130
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3236
Mailing Address - Country:US
Mailing Address - Phone:866-307-5484
Mailing Address - Fax:949-710-6127
Practice Address - Street 1:12222 MERIT DR STE 130
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3236
Practice Address - Country:US
Practice Address - Phone:866-307-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty