Individual
DR. HEZEKIAH OLUWAROTIMI SOBAMOWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10730 POTRANCO RD STE 122-507, SAN ANTONIO, TX 78251-3327
(337) 433-8400
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
204750
LA
207R00000X
Internal Medicine Physician
FR0435669053
NY
207RC0000X
Cardiovascular Disease Physician
MD.204750
LA
207RN0300X
Nephrology Physician
Primary
P1595
TX
208M00000X
Hospitalist Physician
P1595
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08770558
—
MS
05
—
2159658
—
LA
Enumeration date
08/08/2010
Last updated
12/19/2023
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