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4848 Ne Stallings Dr Ste 103 Nacogdoches TX 75965-1208 | |
| (936) 560-2250 | |
| (936) 560-2316 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 4848 Ne Stallings Dr Ste 103, Nacogdoches, Texas |
| Authorized Official Name and Position | Olufemi T Oladele-ajose (MD) |
| Authorized Official Contact | 9365602250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4848 Ne Stallings Dr Ste 103 Nacogdoches TX 75965-1208 Ph: (936) 560-2250 | 4848 Ne Stallings Dr Ste 103 Nacogdoches TX 75965-1208 Ph: (936) 560-2250 |
| NPI Number | 1952673287 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952673287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | N9394 (Texas) | Primary |
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