Healthcare Provider Details

I. General information

NPI: 1831320035
Provider Name (Legal Business Name): AKINOLUWA JOSEPH OLUWATOMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BABCOCK RD STE 111
SAN ANTONIO TX
78229-4899
US

IV. Provider business mailing address

PO BOX 734812
DALLAS TX
75373-0001
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-3108
  • Fax: 210-702-4750
Mailing address:
  • Phone: 210-358-5100
  • Fax: 210-358-9183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD446378
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberS4362
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: