Provider Demographics
NPI:1871583526
Name:SANUSI, OLADAYO A (MD)
Entity type:Individual
Prefix:
First Name:OLADAYO
Middle Name:A
Last Name:SANUSI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6639
Mailing Address - Country:US
Mailing Address - Phone:956-351-5087
Mailing Address - Fax:956-805-5028
Practice Address - Street 1:1412 E 8TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6639
Practice Address - Country:US
Practice Address - Phone:956-351-5087
Practice Address - Fax:956-805-5028
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMO899207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175603302Medicaid
TX175603302Medicaid
TX8F2833Medicare PIN