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Organization

OWOLABI JR. HOLDINGS LLC

Active
Other names
Metro Foot & Ankle Specialists
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS ADEKUNLE OWOLABI JR. DPM (MANAGING MEMBER)
(832) 515-9249
Entity
Organization

Contact information

Practice address
2205 WILLIAMS TRACE BLVD STE 106, SUGAR LAND, TX 77478-4443
(281) 891-3668
Mailing address
1519 TYLER POINT LN, PEARLAND, TX 77089-1453
(832) 515-9249

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1403131333
BLUECROSS BLUESHIELD OF TEXAS
TX
05
441157101
TX
Enumeration date
10/19/2022
Last updated
10/19/2022
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