Provider Demographics
NPI:1972895522
Name:MARY OLADUNNI BAIYERI M.D., P.A
Entity type:Organization
Organization Name:MARY OLADUNNI BAIYERI M.D., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIYERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-416-8887
Mailing Address - Street 1:1400 W NORTHWEST HWY STE 280
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8120
Mailing Address - Country:US
Mailing Address - Phone:817-416-8887
Mailing Address - Fax:817-416-8878
Practice Address - Street 1:1400 W NORTHWEST HWY STE 280
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8120
Practice Address - Country:US
Practice Address - Phone:817-416-8887
Practice Address - Fax:817-416-8878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty