Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | M8049 | TX |
NPI | 1407048267 |
---|---|
Provider Name | Dr. Modupe Idowu |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-1555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 30/09/2021 |