Individual provider Active NPI

Oluwadamilola Ayanda

  • Pharmacist
  • Red Oak, TX
National Provider Identifier
1346019452
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73600 Issued in TX
Practice address
105 Harris Ave
Red Oak, TX 75154-4216
Phone
(972) 617-0034
NPI assigned
Dec 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73600 TX Primary

Addresses

Primary practice location

105 Harris Ave
Red Oak, TX 75154-4216

Mailing address

3507 Walnut Ridge Dr
Midlothian, TX 76065-5378
Phone (682) 718-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
73600TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1346019452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 WALNUT RIDGE DR",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655378",
            "telephone_number": "682-718-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HARRIS AVE",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751544216",
            "telephone_number": "972-617-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYANDA",
        "first_name": "OLUWADAMILOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "73600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.