Organization
COLLAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLINS ADEAGBO (MANAGER)
(469) 463-3061
Entity
Organization
Contact information
Practice address
207 BALSAM GROVE CIR, DESOTO, TX 75115-5361
(469) 463-3061
Mailing address
207 BALSAM GROVE CIR, DESOTO, TX 75115-5361
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2556790
TX
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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