Individual
COLLINS ADEAGBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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
246Z00000X
Other Specialist/Technologist
2556790
TX
247000000X
Health Information Technician
2355690
TX
251E00000X
Home Health Agency
Primary
255690
TX
251K00000X
Public Health or Welfare Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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