Individual
MOBOLAJI ODELOWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S CONROE MEDICAL DR STE 102, CONROE, TX 77304-5341
(936) 539-4031
(936) 539-4537
Mailing address
600 S CONROE MEDICAL DR STE 102, CONROE, TX 77304-5341
(936) 539-4031
(936) 539-4537
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L9832
TX
2085R0202X
Diagnostic Radiology Physician
L9832
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
L9832
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003RP
BCBS GROUP
TX
01
—
00Z8364
MEDICARE GROUP
TX
05
—
171710003
—
TX
01
—
203040501
MEDICAID GROUP
TX
01
—
8BK450
BCBS
TX
Enumeration date
05/10/2006
Last updated
12/12/2025
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