Organization Active NPI

Mobolaji Odelowo M.D., P.a.

Doing business as Endovascular & Interventional Associates

  • Vascular & Interventional Radiology Physician
  • Conroe, TX
National Provider Identifier
1922271295
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
MOBOLAJI ODELOWO M.D., P.A.
Doing business as
Endovascular & Interventional Associates
Practice address
600 S Conroe Medical Dr Ste 102
Conroe, TX 77304-5341
Phone
(936) 539-4031
Fax
(936) 539-4537
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Oluwaseun Odelowo
Title
Administrator
Phone
(936) 539-4031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 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

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

Other names 1

  • Endovascular & Interventional Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000413 TX Part B Supplier - Clinic/Group Practice 0143393629 Receives reassigned benefits from 1 practitioner
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1922271295",
    "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": "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": {
        "organization_name": "MOBOLAJI ODELOWO M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "ODELOWO",
        "authorized_official_first_name": "OLUWASEUN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "936-539-4031"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endovascular & Interventional Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.