Olusola, Benedict O

Olusola, Benedict O is an sole proprietor health care provider with primary practice located at 1700 N Hampton Rd Suite 100, Desoto TX 75115-2392. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Olusola, Benedict O can be contacted via phone (972) 228-3677.

Contact Information

Primary practice address
1700 N Hampton Rd Suite 100 Desoto TX 75115-2392
Phone: (972) 228-3677
Fax: (972) 228-3672
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X J7118 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X J7118 Texas

Profile Details

NPI number 1376566125
LBN Legal business name Olusola, Benedict O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2006
Last updated Oct 2nd, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376566125 NPPES
Texas MEDICAID 139957825
Texas Other 0032QR

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