Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. AGBOLADE O. ODUTAYO, D.O.
Active Sole ProprietorDR. AGBOLADE O. ODUTAYO, D.O. is a Emergency Medicine healthcare provider located in CAMERON, Texas. NPI 1316992779 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · CAMERON, TX
Registration Details
- NPI Number
- 1316992779
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 24, 2006 (20.215570881349 yrs)
- Last Updated
- Jan 29, 2024
- Licenses
-
K6196 (TX)K6196 (TX)K6196 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
300 W 4TH STCAMERON, TX, 765202509Browse TX providers · Browse ZIP 76520
- Phone
- 2546973100
- Fax
- 2546973112
- Primary Specialty
-
Emergency Medicine
207P00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Emergency Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.