Provider Demographics
NPI:1619989142
Name:NJAMFA, LYDIA OLUWATOYIN (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:OLUWATOYIN
Last Name:NJAMFA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 W SPRING VALLEY RD
Mailing Address - Street 2:SUITE 399
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7216
Mailing Address - Country:US
Mailing Address - Phone:214-570-9400
Mailing Address - Fax:972-792-7268
Practice Address - Street 1:708 W SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7216
Practice Address - Country:US
Practice Address - Phone:214-570-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10017340OtherAMERIGROUP
TX1703118-01Medicaid
TX1703118-02Medicaid
TX1703118-01Medicaid
TXH77232Medicare UPIN