Organization · NPI-2

Adolphus Medical Group

Family Medicine · Dallas, TX

NPI number1447531876
StatusActive
Last updated in NPPESAug 30, 2011

Details

NPI
1447531876
Entity type
Organization (NPI-2)
Legal business name
Adolphus Medical Group
Organization subpart
No
Enumeration date
Aug 30, 2011
Last updated
Aug 30, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineN9413TXYes

Practice location

406 E Camp Wisdom Rd
Suite A
Dallas, TX 75241

Phone 682-478-9117 · Fax 817-887-2305

Mailing address

2515 Mckinney Ave
Suite 940
Dallas, TX 75201-1908

Phone 682-478-9117 · Fax 817-887-2305

Authorized official

Grace Stanley
Director
8176149180

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