Physician Compare National (NPI:1023383205)

HEALTHCARE PROVIDER: ADEBOLA IBILOLA FALAE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1023383205
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406143023
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160926002135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FALAE
	Individual professional last name
Provider First Name	ADEBOLA
	Individual professional first name
Provider Middle Name	IBILOLA
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	T.L. JENKINS M.D., P.A.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5193722502
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	23535 KINGSLAND BLVD
	Group Practice or individual's line 1 address
City	KATY
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	774943962
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2813472600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y