Individual
ADEBOWALE ALAO ADEDEJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OWNER/CEO
Contact information
Practice address
2613 HAWCO DR APT 1822, 2613 HAWCO DR APT 1822, GRAND PRAIRIE, TX 75052-7668
(214) 705-5047
Mailing address
2613 HAWCO DR APT 1822, 2613 HAWCO DR APT 1822, GRAND PRAIRIE, TX 75052-7668
(214) 705-5047
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
261QH0100X
TX
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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