OLANREWAJU AWOFESO
NPI 1336622141
Nursing Home Administrator in Tyler, TX
Active since September 09, 2018
About Olanrewaju Awofeso NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLANREWAJU AWOFESO (NPI 1336622141) is an individual nursing home administrator provider in Tyler, Texas, licensed in Texas (9367) and active in the NPI registry since September 2018.
NPPES Registry Identity
NPI1336622141
Entity TypeIndividualMale
Primary Taxonomy376G00000X
Provider Legal NameOLANREWAJU AWOFESO
Location Address2818 SHADY LNTyler, TX 75702-7745
Mailing Address2818 Shady LnTyler, TX 75702-7745 · (210) 264-9748
Phone(210) 264-9748
Sole ProprietorYes
Enumeration DateSeptember 9, 2018
✔ NPI 1336622141 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNursing Home AdministratorNursing Service Related Providers
Taxonomy Code376G00000X
License✔ Licensed in TX · 9367
Definition
An individual, often licensed by the state, who is responsible for the management of a nursing home.
2818 SHADY LN, Tyler, TX 75702
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336622141, enumerated as an "individual" on September 09, 2018.
The provider is located at 2818 SHADY LN TYLER, TX 75702 and the phone number is (210) 264-9748.
Nursing Home Administrator with taxonomy code 376G00000X.
