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Organization
KIFLE ADMASSU MD PA
Active
Organization
KIFLE ADMASSU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIFLE ADMASSU MD (PRESIDENT AND CEO)
(817) 960-6648
Entity
Organization
Contact information
Practice address
305 HAWKS RIDGE TRL, COLLEYVILLE, TX 76034-8213
(817) 960-6648
(817) 960-6649
Mailing address
305 HAWKS RIDGE TRL, COLLEYVILLE, TX 76034-8213
(817) 960-6648
(817) 960-6649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M1448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X656
NEW MEDICARE NUMBER
TX
01
—
612406
OTHER MEDICARE #
TX
01
—
M1448
LICENSE
TX
Enumeration date
05/10/2007
Last updated
06/26/2015
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