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Organization
SEQUOYAH CARE PLLC
Active
Organization
SEQUOYAH CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADOLPHUS V GIST MD (PRESIDENT)
(972) 216-9511
Entity
Organization
Contact information
Practice address
828 KIRKWOOD DR, DALLAS, TX 75218-2208
(972) 216-9511
(972) 216-9580
Mailing address
PO BOX 851438, MESQUITE, TX 75185-1438
(972) 216-9511
(972) 216-9580
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A5058
MEDICARE GROUP
TX
05
—
168406007
—
TX
Enumeration date
07/06/2009
Last updated
08/22/2014
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