Fatiregun, Agboola O
Fatiregun, Agboola O is an individual health care provider with primary practice located at 3501 N Macarthur Blvd Ste 450 , Irving TX 75062-3651. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fatiregun, Agboola O can be contacted via phone (972) 786-0330.Contact Information
Primary practice address
3501 N Macarthur Blvd Ste 450
Irving TX 75062-3651
Phone: (972) 786-0330
Fax: (972) 739-2894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 220389 | New York |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | M7173 | Texas |
Profile Details
| NPI number | 1134128101 |
|---|---|
| LBN Legal business name | Fatiregun, Agboola O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Oct 16th, 2020 - about 4 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 | 1134128101 | NPPES |
| Texas | MEDICAID | 189208501 | |
| Texas | Other | 8W4546 |
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