National Provider Identifier Database

OLUWAYEMISI O AGBOOLA, FNP – NPI #1114210648
Family


Contact Information

OLUWAYEMISI O AGBOOLA, FNP
855 MONTGOMERY ST
FORT WORTH, TX76107-2553
Phone: 817-702-6100
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for OLUWAYEMISI O AGBOOLA

NPI Number 1114210648
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 05/17/2011
Last updated 10/16/2014 - About 12 years ago
Sole proprietor1 No
Identifiers
  • PA License #: SP010939
  • TX License #: 798878
  • TX Medicaid: 295160004
  • TX Other: 8562NK BCBS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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