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Individual

MRS. MODUPE ARINUKE SOKUNBI

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
626 RUSSELL BLVD, SUITE A, NACOGDOCHES, TX 75965
(936) 552-7216
(936) 552-7274
Mailing address
626 RUSSELL BLVD, SUITE A, NACOGDOCHES, TX 75965
(936) 552-7216
(936) 552-7274

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J7204
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000072BK
BCBS
TX
Enumeration date
03/24/2006
Last updated
07/08/2007
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