Provider Demographics
NPI:1891256616
Name:BAKRE, SULAIMON ADEBIMPE (MD)
Entity Type:Individual
Prefix:DR
First Name:SULAIMON
Middle Name:ADEBIMPE
Last Name:BAKRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 MEDLIN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2307
Mailing Address - Country:US
Mailing Address - Phone:682-382-3435
Mailing Address - Fax:
Practice Address - Street 1:3019 MEDLIN DR STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2307
Practice Address - Country:US
Practice Address - Phone:682-382-3435
Practice Address - Fax:720-794-8635
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU03012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
390200000XOtherSTUDENT, HEALTH CARE