Individual
IYABODE AJIBOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3508 FAR WEST BLVD, AUSTIN, TX 78731-3080
(512) 828-3990
Mailing address
3508 FAR WEST BLVD STE 130, AUSTIN, TX 78731-3081
(512) 828-3990
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
919453
TX
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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