Individual
MFONOBONG I OKUBADEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5282 MEDICAL DR STE 180, SAN ANTONIO, TX 78229-5384
(210) 450-9850
(210) 450-6095
Mailing address
5282 MEDICAL DR STE 180, SAN ANTONIO, TX 78229-5384
(210) 450-9850
(210) 450-6095
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
S9575
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
S9575
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428794801
—
TX
01
—
428794802
CSHCN
TX
Enumeration date
07/15/2016
Last updated
03/09/2022
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