MS. JOANN MODUPE BOLUDE (NPI# 1255666335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255666335 |
| Entity Type | Individual |
| Full Name | MS. JOANN MODUPE BOLUDE |
| Credential | M.D. |
| Practice Address |
105 S. Stewart Cotulla TX 78014-7801 |
| Mailing Address |
105 S. Stewart Cotulla TX 78014-1013 |
| Practice Telephone | 8308793047 |
| Practice Fax Number | 8779920112 |
| Mailing Telephone | 8308793047 |
| Mailing Fax Number | 2102776387 |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2019-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Q5763 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 365574801 | 05 |
| Street Address |
105 S. STEWART |
| City | COTULLA |
| State | TX |
| Zip Code | 78014-7801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538351770 | South Texas Rural Health Services Inc. | Community/Behavioral Health | 105 S. Stewart, Cotulla, TX 78014-0599 | 2007-08-13 |
| 1447884036 | Garry Magpily | Nurse Practitioner | 105 S. Stewart, Cotulla, TX 78014-7801 | 2020-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902363807 | South Texas Rural Health Services, Inc. | Clinic/Center | 651 N. Baylor, Cotulla, TX 78014 | 2019-02-27 |
| 1417412776 | Saimol Thomas | Nurse Practitioner | 611 Thornton, Cotulla, TX 78014 | 2019-01-31 |
| 1346713534 | Maria Dolores Castro | Student in an Organized Health Care Education/Training Program | 105 Stewart, Cotulla, TX 78014 | 2019-01-10 |
| 1902372568 | Elizabeth Marie Lutz | Specialist/Technologist | 310 N. Main St., Cotulla, TX 78014 | 2018-10-22 |
| 1699140392 | Rebecca Renae Valdez | Counselor | 105 South Stewart Street, Cotulla, TX 78014 | 2015-12-07 |
| 1053733014 | Dora A. Fast | Nurse Practitioner | 105 S. Stewart St., Cotulla, TX 78014 | 2014-01-10 |
| 1376800151 | Juanita M Kulesza | Counselor | 611 Thornton Street, Cotulla, TX 78014 | 2012-04-18 |
| 1154648459 | County of Lasalle | Skilled Nursing Facility | 369 Mars Drive, Cotulla, TX 78014 | 2010-04-26 |
| 1295934420 | Ma Angela S Garner | Physical Therapist | 506 N Main Street, #501, Cotulla, TX 78014 | 2007-07-17 |
| 1033317987 | Melinda Ann Haley Bailey | Counselor | 611 Thorton St, Cotulla, TX 78014 | 2007-07-03 |
| Find all providers in zip 78014 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366960221 | South Texas Rural Health Services, Inc. | General Practice | 105 S Stewart, Cotulla, TX 78014-3003 | 2017-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577392 | Best Americare Visiting Doctors, Inc. | General Practice | 13601 Preston Rd Ste 706w, Dallas, TX 75240-5361 | 2020-10-30 |
| 1659978401 | Instaclinic, LLC | General Practice | 7008 Quartermile Ln, Dallas, TX 75248-1448 | 2020-10-05 |
| 1649887068 | Online Care Group Texas P.a. | General Practice | 6213 County Road 308, Rosharon, TX 77583-6321 | 2020-09-29 |
| 1689288342 | Nortex Medical Group | General Practice | 981 State Highway 121 Ste 4150, Allen, TX 75013 | 2020-09-01 |
| 1518577485 | Advanced Lifestyle Solutions Pllc | General Practice | 9560 Legacy Dr Ste 260, Frisco, TX 75033-6753 | 2020-08-05 |
| 1023627569 | Shepcole, Inc. | General Practice | 1431 Greenway Dr Ste 8000, Irving, TX 75038-2448 | 2020-07-30 |
| 1376151472 | Canice Chukwuocha | General Practice | 3030 Elmside Dr Apt 179, Houston, TX 77042-3926 | 2020-07-15 |
| 1902424518 | Medkare | General Practice | 2426 Lake Kolbe Ln, Houston, TX 77080-2562 | 2020-07-09 |
| 1528683810 | Umc El Paso Healthcare Inc | General Practice | 7500 Viscount Blvd Ste 140, El Paso, TX 79925-5692 | 2020-06-11 |
| 1770107542 | Texas Integrative Wellness Pllc | General Practice | 21660 Kingsland Blvd Ste 200, Katy, TX 77450-2511 | 2020-06-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. JOANN MODUPE BOLUDE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.