Organization
ARLINGTON INFECTIOUS DISEASE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLENI WOLDESENBET M.D. (OWNER)
(817) 417-0260
Entity
Organization
Contact information
Practice address
3132 MATLOCK RD, SUITE 309, ARLINGTON, TX 76015-2910
(817) 417-0260
(817) 417-4834
Mailing address
2718 SHADOW WOOD DR, ARLINGTON, TX 76006-2724
(817) 608-0625
(817) 810-9815
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
L0707
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094LZ
BCBS OF TX
TX
01
—
DC6184
RAILROAD MEDICARE
TX
Enumeration date
10/18/2007
Last updated
12/14/2007
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