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Organization
WISDOM HEALTHCARE CLINIC N HEALTHCARE SERVICES INC
Active
Organization
WISDOM HEALTHCARE CLINIC N HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A BADEJO PA (DIRECTOR)
(972) 436-1811
Entity
Organization
Contact information
Practice address
403 W MAIN ST, SUITE B, LEWISVILLE, TX 75057-3757
(817) 200-6189
(469) 464-4398
Mailing address
403 W MAIN ST, SUITE B, LEWISVILLE, TX 75057-3757
(817) 200-6189
(469) 464-4398
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA04564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1067786
NCCPA
TX
05
—
198899001
—
TX
01
—
PA04564
LICENSE
TX
Enumeration date
06/03/2008
Last updated
01/16/2010
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