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Individual

FIDELIS EZE AMADI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4100 EVERETT DR, SUITE 400, KYLE, TX 78640-6146
(512) 295-1333
(512) 295-1335
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L9069
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175790801
TX
05
175790802
TX
05
175790803
TX
Enumeration date
11/22/2005
Last updated
10/08/2013
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