# NEW HAVEN MHT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356767305
- **Authorized official:** ANTHONY ADEOSUN M.D. (OWNER)
- **Authorized official phone:** (855) 860-2109

## Contact information

- **Practice address:** 333 DOCTOR MICHAEL DEBAKEY DR, SUITE 120, LAKE CHARLES, LA 70601-5887
- **Practice address phone:** (855) 860-2109
- **Mailing address:** 1515 HERITAGE DRIVE, SUITE 110, MCKINNEY, TX 75069-3379
- **Mailing address phone:** (972) 616-4702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD.202004 | LA | Yes |

## Other

- **Enumeration date:** 03/14/2014
- **Last updated:** 07/31/2014