Provider Demographics
NPI:1053564476
Name:AINA, OLUFEMI (RN)
Entity type:Individual
Prefix:
First Name:OLUFEMI
Middle Name:
Last Name:AINA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10935 ESTATE LN
Mailing Address - Street 2:STE 100J
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2316
Mailing Address - Country:US
Mailing Address - Phone:972-553-0592
Mailing Address - Fax:972-553-9271
Practice Address - Street 1:10935 ESTATE LN
Practice Address - Street 2:STE 100J
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:972-553-0592
Practice Address - Fax:972-553-9271
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010280251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743143Medicare Oscar/Certification