Provider Demographics
NPI:1578853941
Name:SOBANDE, THOMAS BABATUNDE (RN)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BABATUNDE
Last Name:SOBANDE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 WINDSWEPT DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3121
Mailing Address - Country:US
Mailing Address - Phone:214-893-4932
Mailing Address - Fax:
Practice Address - Street 1:821 WINDSWEPT DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3121
Practice Address - Country:US
Practice Address - Phone:214-893-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX787787163WA2000X, 163WH0200X, 163WM0705X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No251E00000XAgenciesHome Health