| Oladele Olusanya Md Pa | |
|
8067 West Virginia Dr Dallas TX 75237-3767 | |
| (972) 230-5601 | |
| (972) 230-5591 |
| Full Name | Oladele Olusanya Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 8067 West Virginia Dr, Dallas, Texas |
| Authorized Official Name and Position | Oladele O Olusanya (PRESIDENT) |
| Authorized Official Contact | 9722305601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oladele Olusanya Md Pa 8067 West Virginia Dr Dallas TX 75237-3767 Ph: (972) 230-5601 | Oladele Olusanya Md Pa 8067 West Virginia Dr Dallas TX 75237-3767 Ph: (972) 230-5601 |
| NPI Number | 1417078411 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 06/06/2012 |
| Medicare PECOS PAC ID | 4789780784 |
|---|---|
| Medicare Enrollment ID | O20070511000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417078411 | NPI | - | NPPES |
| 153097402 | Other | TX | MEDICAID THSTEPS |
| 153097401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K8398 (Texas) | Primary |
| Provider Name | Oladele O Olusanya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073542429 PECOS PAC ID: 6800887886 Enrollment ID: I20040519000700 |
Perry K. Beckstrom, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3946 S Buckner Blvd Ste 200, Dallas, TX 75227 Phone: 214-381-7194 Fax: 214-381-7195 | |
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Oakcliff Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 817 W Jefferson Blvd, Dallas, TX 75208 Phone: 214-941-5777 Fax: 214-941-5131 | |
Premier Medical Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8300 Douglas Ave Suite 800, Dallas, TX 75225 Phone: 817-381-6813 | |
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