Individual
ADEBISI BOLANLE ADEBAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10439 CEDAR VLG, SAN ANTONIO, TX 78245-3114
(210) 725-4428
Mailing address
9018 HIGH BR, SAN ANTONIO, TX 78254-4411
(210) 571-3344
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
227729
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W236704416
AETNA
AK
Enumeration date
08/14/2018
Last updated
08/14/2018
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