Organization
MICABY MEDICAL,PLLC
Active
Other names
MICABY MEDICAL,PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEZEKIAH OLUWAROTIMI SOBAMOWO MD (PRESIDENT)
(615) 397-0896
Entity
Organization
Contact information
Practice address
10730 POTRANCO RD STE 122-507, SAN ANTONIO, TX 78251-3327
(210) 858-7604
(210) 888-0383
Mailing address
1222 MCCULLOUGH AVE STE 101, SAN ANTONIO, TX 78212-4812
(210) 858-7604
(210) 888-0383
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
10/14/2020
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