Individual
EMMANUEL GBOLABO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3522 BURDOCK LANE, FARMERS BRANCH, TX 75234
(817) 691-1582
Mailing address
3522 BURDOCK LANE, FARMERS BRANCH, TX 75234
(817) 691-1582
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11134
TX
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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