Dr Iyabo a Elemuren-Ogunmuyiwa PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K4050 Issued in TX

Legal business name

DR IYABO A ELEMUREN-OGUNMUYIWA PA

Practice address

813 S Amy LN
Suite 101
Harker Heights, TX 76548-1953

Phone

(254) 699-8521

Fax

(254) 213-1509

NPI assigned

Mar 17, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Iyabo A Elemuren-Ogunmuyiwa, MDNPI 1326113218

Title

Owner

Phone

(254) 699-8521

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iyabo A Elemuren-Ogunmuyiwa, M.D

  • Family Medicine Physician
  • Harker Heights, TX
  • NPI 1326113218
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1124569587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 S AMY LN",
            "address_2": "SUITE 101",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481953",
            "telephone_number": "254-699-8521",
            "fax_number": "254-213-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 S AMY LN",
            "address_2": "SUITE 101",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481953",
            "telephone_number": "254-699-8521",
            "fax_number": "254-213-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR IYABO A ELEMUREN-OGUNMUYIWA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "ELEMUREN-OGUNMUYIWA",
        "authorized_official_first_name": "IYABO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-699-8521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K4050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Sue Dolifka, LPC
• Mikaya Donald
• Dora Services LLC
• Soraya S Doswell, LMT
• Brianna Douglas
• Rebecca Jean Droge
• Lauren Dubois
• John Patrick Duggan Jr., MD
• Karen Dawn Pence Dukes, FNP
• Melinda Ellen Duncan, D.D.S.

• Family Medicine Physician in Harker Heights, TX
• Providers in Harker Heights, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.