Omotola, Michael G

Omotola, Michael G is an individual health care provider with primary practice located at 2520 W I 20 , Grand Prairie TX 75052-7280. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Omotola, Michael G can be contacted via phone (512) 363-3257.

Contact Information

Primary practice address
2520 W I 20 Grand Prairie TX 75052-7280
Phone: (512) 363-3257
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1124505615
LBN Legal business name Omotola, Michael G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2018
Last updated Jul 26th, 2018 - about 8 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.

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