Individual
BOLANLE O. GBADEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9939 STATE HIGHWAY 151, SAN ANTONIO, TX 78251-1900
(210) 949-9702
(210) 443-0333
Mailing address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(920) 217-0539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28814
AL
207Q00000X
Family Medicine Physician
Primary
46201
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34586000
—
WI
Enumeration date
10/16/2006
Last updated
03/05/2025
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