Provider Demographics
NPI:1609544162
Name:SHOBAJO, KAFILAT (NP)
Entity type:Individual
Prefix:
First Name:KAFILAT
Middle Name:
Last Name:SHOBAJO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 BROADWAY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4915
Mailing Address - Country:US
Mailing Address - Phone:281-412-0508
Mailing Address - Fax:281-741-9076
Practice Address - Street 1:2705 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4915
Practice Address - Country:US
Practice Address - Phone:281-412-0508
Practice Address - Fax:281-741-9076
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023884363LF0000X
TX1143027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily