Provider Demographics
NPI:1457585739
Name:SALMON, OLAYIWOLA ABDULLATEEF (MD)
Entity type:Individual
Prefix:
First Name:OLAYIWOLA
Middle Name:ABDULLATEEF
Last Name:SALMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17407 ASTRACHAN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2703
Mailing Address - Country:US
Mailing Address - Phone:832-274-6476
Mailing Address - Fax:
Practice Address - Street 1:18220 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-737-0587
Practice Address - Fax:662-772-2960
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20974207R00000X
LAMD.202977207R00000X
TXN5991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB133326Medicare PIN