Organization
ADESUBOMI AGORO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADESUBOMI AGORO (OWNER)
(817) 763-5550
Entity
Organization
Contact information
Practice address
1100 PENNSYLVANIA AVENUE, FORT WORTH, TX 76104-2120
(817) 763-5550
(817) 763-5715
Mailing address
1100 PENNSYLVANIA AVENUE, FORT WORTH, TX 76104-2120
(817) 763-5550
(817) 763-5715
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
K2394
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K2394
TEXAS LICENSE NUMBER
TX
Enumeration date
01/08/2010
Last updated
02/22/2010
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