Komolafe, Babatunde O.
Komolafe, Babatunde O. is an sole proprietor health care provider with primary practice located at 2800 E Broad St Ste 204 , Mansfield TX 76063-6411. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Komolafe, Babatunde O. can be contacted via phone (817) 752-5242.Contact Information
Primary practice address
2800 E Broad St Ste 204
Mansfield TX 76063-6411
Phone: (817) 752-5242
Fax: (817) 752-5232
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 33580 | Alabama |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | Q0486 | Texas |
Profile Details
| NPI number | 1376752048 |
|---|---|
| LBN Legal business name | Komolafe, Babatunde O. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 21st, 2007 |
| Last updated | Jan 24th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376752048 | NPPES |
| Alabama | MEDICAID | 165521 | |
| Alabama | MEDICAID | 407447803 |
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