Individual provider · NPI-1

Dr. Moyosade Adeyinka Ajala, MD

Family Medicine · Grand Prairie, TX

NPI number1346435815
StatusActive
Last updated in NPPESSep 9, 2011

Details

NPI
1346435815
Entity type
Individual (NPI-1)
Name
Dr. Moyosade Adeyinka Ajala
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Sep 7, 2007
Last updated
Sep 9, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineN8264TXYes
390200000X Student in an Organized Health Care Education/Training ProgramBP10027990TX

Practice location

410 E Pioneer Pkwy
Suite 300
Grand Prairie, TX 75051-4983

Phone 469-733-1890 · Fax 469-733-1894

Mailing address

300 E John Carpenter Fwy
Suite 850
Irving, TX 75062-2727

Phone 972-957-3000 · Fax 972-957-3005

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