Agboola, Oluwayemisi O
Agboola, Oluwayemisi O is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Agboola, Oluwayemisi O can be contacted via phone (817) 702-6100.Contact Information
Primary practice address
855 Montgomery St
Fort Worth TX 76107-2553
Phone: (817) 702-6100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | SP010939 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 798878 | Texas |
Profile Details
| NPI number | 1114210648 |
|---|---|
| LBN Legal business name | Agboola, Oluwayemisi O |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2011 |
| Last updated | Oct 16th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114210648 | NPPES |
| Texas | MEDICAID | 295160004 | |
| Texas | Other | 8562NK |
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