Provider Demographics
NPI:1699267666
Name:AIMUYO, OSARETIN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:OSARETIN
Middle Name:CHARLES
Last Name:AIMUYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:3131 S CENTER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2007
Practice Address - Country:US
Practice Address - Phone:817-375-1413
Practice Address - Fax:817-375-9101
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA00000208000000X
TXT8161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics