Patti Burk Olusola, MD
Family Medicine in Tyler, TX. Individual provider (NPI-1).
NPI number1962490953
StatusActive
Last updated in NPPESOct 5, 2016
Details
- NPI
- 1962490953
- Entity type
- Individual (NPI-1)
- Name
- Patti Burk Olusola
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2005
- Last updated
- Oct 5, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | L3595 | TX | Yes |
Other names
- Patti Lynn Burk (Former Name)
Practice location
11937 Us Highway 271Tyler, TX 75708-3154
Phone 903-877-7777 · Fax 903-877-5080
Mailing address
Po Box 731912Dallas, TX 75373-1912
Phone 903-877-7777 · Fax 903-877-5080
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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