Bolude, Joann Modupe

Bolude, Joann Modupe is an individual health care provider with primary practice located at 105 S. Stewart , Cotulla TX 78014-7801. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Bolude, Joann Modupe can be contacted via phone (830) 879-3047.

Contact Information

Primary practice address
105 S. Stewart Cotulla TX 78014-7801
Phone: (830) 879-3047
Fax: (877) 992-0112
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Q5763 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X Q5763 Texas

Profile Details

NPI number 1255666335
LBN Legal business name Bolude, Joann Modupe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2009
Last updated Sep 12th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255666335 NPPES
Texas MEDICAID 365574801

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