Individual
EJODAMEN BLESSING SHOBOWALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
15003 FM 529 RD STE B, HOUSTON, TX 77095-4379
(832) 415-1790
(281) 619-7998
Mailing address
15003 FM 529 RD, HOUSTON, TX 77095-4375
(832) 819-3511
(281) 619-7998
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003VAA
BCBS TX
TX
05
—
375642101
—
TX
05
—
375642102
—
TX
05
—
375642103
—
TX
05
—
375642104
—
TX
05
—
375642105
—
TX
05
—
375642106
—
TX
05
—
375642107
—
TX
Enumeration date
06/27/2014
Last updated
09/03/2021
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