| Dr Iyabo A Elemuren-ogunmuyiwa Pa | |
|
813 S Amy Ln Suite 101 Harker Heights TX 76548-1953 | |
| (254) 699-8521 | |
| (254) 213-1509 |
| Full Name | Dr Iyabo A Elemuren-ogunmuyiwa Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 813 S Amy Ln, Harker Heights, Texas |
| Authorized Official Name and Position | Iyabo A Elemuren-ogunmuyiwa (OWNER) |
| Authorized Official Contact | 2546998521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Iyabo A Elemuren-ogunmuyiwa Pa 813 S Amy Ln Suite 101 Harker Heights TX 76548-1953 Ph: (254) 699-8521 | Dr Iyabo A Elemuren-ogunmuyiwa Pa 813 S Amy Ln Suite 101 Harker Heights TX 76548-1953 Ph: (254) 699-8521 |
| NPI Number | 1124569587 |
|---|---|
| Provider Enumeration Date | 03/17/2017 |
| Last Update Date | 03/17/2017 |
| Medicare PECOS PAC ID | 6709163462 |
|---|---|
| Medicare Enrollment ID | O20170505000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124569587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K4050 (Texas) | Primary |
| Provider Name | Iyabo A Elemuren-ogunmuyiwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326113218 PECOS PAC ID: 0244317303 Enrollment ID: I20110503000470 |
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