Provider Demographics
NPI:1669619235
Name:INKERRA MEDICAL PC
Entity type:Organization
Organization Name:INKERRA MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IFEOLUMIPO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOFOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-729-7456
Mailing Address - Street 1:7901 RESEARCH FOREST DR STE 1400
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1485
Mailing Address - Country:US
Mailing Address - Phone:832-729-7456
Mailing Address - Fax:832-415-9542
Practice Address - Street 1:7901 RESEARCH FOREST DR STE 1400
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1485
Practice Address - Country:US
Practice Address - Phone:832-729-7456
Practice Address - Fax:832-415-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-19
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty