Provider Demographics
NPI:1386061620
Name:AYODELE O. OLOWOOKERE, M.D., P.A
Entity type:Organization
Organization Name:AYODELE O. OLOWOOKERE, M.D., P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AYODELE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLOWOOKERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-599-3812
Mailing Address - Street 1:5317 SHADY BEND CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-1400
Mailing Address - Country:US
Mailing Address - Phone:432-599-3812
Mailing Address - Fax:
Practice Address - Street 1:5317 SHADY BEND CT
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-1400
Practice Address - Country:US
Practice Address - Phone:432-599-3812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty