Mariam Folakemi Afolabi, PA-C
Physician Assistant in Fort Worth, TX. Individual provider (NPI-1).
NPI number1801592613
StatusActive
Last updated in NPPESApr 2, 2024
Details
- NPI
- 1801592613
- Entity type
- Individual (NPI-1)
- Name
- Mariam Folakemi Afolabi
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 2, 2023
- Certification date
- Apr 2, 2024
- Last updated
- Apr 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA17074 | TX | Yes |
| 363AM0700X | Physician Assistant, Medical | MA064194 | PA |
Practice location
1500 Cooper StFort Worth, TX 76104-2710
Phone 682-885-2140 · Fax 817-332-2506
Mailing address
Po Box 733784Dallas, TX 75373-3784
Phone 682-885-6483 · Fax 682-885-3113
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