Individual
BABATUNDE ADEBOLA OTINWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6306 FAIRBANKS N HOUSTON RD STE 500, HOUSTON, TX 77040-5193
(832) 831-9094
Mailing address
6302 FAIRBANKS N HOUSTON RD, SUITE 500, HOUSTON, TX 77040
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N5306
TX
207Q00000X
Family Medicine Physician
N5306
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679744676
TRICARE SOUTH
TX
05
—
284813707
—
TX
05
—
284813708
—
TX
05
—
303109801
—
TX
01
—
8DH241
BCBS
TX
01
—
8DL678
BCBS
TX
Enumeration date
03/18/2008
Last updated
04/10/2020
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