Individual
KOFOWOROLA OHIOMOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11714 WILSON PARKE AVE STE 150, AUSTIN, TX 78726-4061
(512) 346-6611
(512) 406-6267
Mailing address
6210 E HWY 290, AUSTIN, TX 78723-1142
(512) 483-9596
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R8067
TX
Other
Enumeration date
04/06/2010
Last updated
01/22/2024
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