Olusola, Patti Burk
Olusola, Patti Burk is an individual health care provider with primary practice located at 11937 Us Highway 271 , Tyler TX 75708-3154. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Olusola, Patti Burk can be contacted via phone (903) 877-7777.Contact Information
Primary practice address
11937 Us Highway 271
Tyler TX 75708-3154
Phone: (903) 877-7777
Fax: (903) 877-5080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | L3595 | Texas |
Profile Details
| NPI number | 1962490953 |
|---|---|
| LBN Legal business name | Olusola, Patti Burk |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Oct 5th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962490953 | NPPES |
| Texas | MEDICAID | 153803501 |
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