Individual
MR. KOLADE BAMIDELE AJAYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
6609 BLANCO RD STE 145, SAN ANTONIO, TX 78216-6179
(210) 940-2764
(830) 239-9930
Mailing address
6609 BLANCO RD STE 145, SAN ANTONIO, TX 78216-6179
(210) 940-2764
(830) 239-9930
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP139704
TX
363LP2300X
Primary Care Nurse Practitioner
AP139704
TX
Other
Enumeration date
01/05/2019
Last updated
12/31/2025
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