NPIMap

Individual provider Active NPI

Mobolaji Odelowo, MD

  • Vascular & Interventional Radiology Physician
  • Conroe, TX
National Provider Identifier
1073562419
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
L9832 Issued in TX
Practice address
600 S Conroe Medical Dr Ste 102
Conroe, TX 77304-5341
Phone
(936) 539-4031
Fax
(936) 539-4537
NPI assigned
May 10, 2006
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L9832 TX
Diagnostic Radiology Physician 2085R0202X L9832 TX
Vascular & Interventional Radiology Physician 2085R0204X L9832 TX Primary

Addresses

Primary practice location

600 S Conroe Medical Dr Ste 102
Conroe, TX 77304-5341

Mailing address

600 S Conroe Medical Dr Ste 102
Conroe, TX 77304-5341
Phone (936) 539-4031

Other practice location 1

2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone (903) 614-1000

Other practice location 2

100 Medical Center Blvd
Suite 118
Conroe, TX 77304-2888
Phone (936) 539-4031

Other identifiers 5

IdentifierTypeStateIssuer
00Z8364OtherTXMEDICARE GROUP
003RPOtherTXBCBS GROUP
171710003MedicaidTX
203040501OtherTXMEDICAID GROUP
8BK450OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000318 TX Practitioner - Interventional Radiology 0143215137 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Radiology PLLCGroup PAC ID 8628332061, 217 clinicians
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians
Cardiac Cath Lab of Conroe, LPGroup PAC ID 4789846262, 8 clinicians

Practice addresses (Care Compare)

110 Memorial Hospital Dr
Huntsville, TX 77340-4940
Phone (888) 264-0330

1110 N Sarah Dewitt Dr
Gonzales Health System
Gonzales, TX 78629-3311
Phone (830) 672-7581

17183 I 45
Suite 350
Shenandoah, TX 77385-3313
Phone (936) 321-0080

600 S Conroe Medical Dr
Suite 102
Conroe, TX 77304-5341
Phone (936) 539-4031

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.18 of 100Reported as group
Quality
85.58
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal63
Leg revascularization (restoring blood flow)37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Cath Lab of Conroe, LP CurrentSince Feb 1, 2012 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 12, 2026 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Nov 1, 2018 Accepting new patients
Diagnostic MRI Central LLC Diagnostic Radiology CurrentSince Nov 27, 2020 Accepting new patients
Concord Radiology PLLC Diagnostic Radiology CurrentSince Feb 7, 2022 Accepting new patients
Coaxion PLLC Diagnostic Radiology CurrentSince May 25, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 12, 2026 Accepting new patients
Mobolaji Odelowo M.D., P.a. Specialist CurrentSince May 17, 2008 Accepting new patients
Vis Procedure Center, PA Specialist Past Accepting new patients
Radiological Consultants, Inc. Diagnostic Radiology Past Accepting new patients
American Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
Vascular & Interventional SP Specialist Past Accepting new patients
Humble Interventional Partners MD PA Vascular & Interventional Radiology PastSince Apr 1, 2020 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

608 Avenue B
Ballinger, TX 76821
Phone (325) 365-2531

100 Medical Center Blvd
Ste 118
Conroe, TX 77304
Phone (936) 539-4031

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

600 S Conroe Medical Dr
Ste 102
Conroe, TX 77304
Phone (936) 304-1166

21214 Northwest Fwy
Cypress, TX 77429
Phone (832) 912-3500

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

6720 Bertner Ave
#270
Houston, TX 77030
Phone (832) 355-4092

110 Memorial Hospital Dr
Huntsville, TX 77340
Phone (936) 291-4276

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

17183 I 45 S
Ste 350
Shenandoah, TX 77385
Phone (936) 321-0080

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: hmhmodelo@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGGCBA/Endpoint/GGGCBA

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1073562419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S CONROE MEDICAL DR STE 102",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045341",
            "telephone_number": "936-539-4031",
            "fax_number": "936-539-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S CONROE MEDICAL DR STE 102",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045341",
            "telephone_number": "936-539-4031",
            "fax_number": "936-539-4537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Saint Michael Dr",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755032372",
            "country_code": "US",
            "telephone_number": "903-614-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Center Blvd",
            "address_2": "Suite 118",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773042888",
            "country_code": "US",
            "telephone_number": "936-539-4031",
            "fax_number": "936-539-4537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODELOWO",
        "first_name": "MOBOLAJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L9832",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L9832",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "L9832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "00Z8364",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "003RP",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171710003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "203040501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BK450",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.