| Doctor Name: | OLUGBEMINIYI I OLUBANJO |
| NPI Number: | 1427274042 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 11012909A |
| Business Practice Address: | 855 Montgomery Fort Worth, TX - 761072553 |
| Business Phone Number: | 8179207000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 99335, FORT WORTH |
| State: | TX |
| Postal Code: | 761990335 |
| Phone Number: | 8179207000 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 09/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11012909A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |