Provider Demographics
NPI:1700011194
Name:BAKER, ABOLAJI B
Entity Type:Individual
Prefix:MR
First Name:ABOLAJI
Middle Name:B
Last Name:BAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 JO LYN LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1724
Mailing Address - Country:US
Mailing Address - Phone:817-683-1872
Mailing Address - Fax:817-394-1229
Practice Address - Street 1:2510 JO LYN LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1724
Practice Address - Country:US
Practice Address - Phone:817-683-1872
Practice Address - Fax:817-394-1229
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator