Provider Demographics
NPI:1841273562
Name:OGUNRO, OLAYINKA (MD)
Entity type:Individual
Prefix:DR
First Name:OLAYINKA
Middle Name:
Last Name:OGUNRO
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 1:7989 W VIRGINIA DR STE 105
Mailing Address - Street 2:# 105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3837
Mailing Address - Country:US
Mailing Address - Phone:972-296-3875
Mailing Address - Fax:972-296-3575
Practice Address - Street 1:7989 W VIRGINIA DR STE 105
Practice Address - Street 2:# 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3837
Practice Address - Country:US
Practice Address - Phone:972-296-3875
Practice Address - Fax:972-296-3575
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1174207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOR98NMedicare ID - Type Unspecified
TXB25245Medicare UPIN