Organization
BOLA ELEMUREN MD. PA
Active
Parent organization
BOLA ELEMUREN MD.PA
Other names
FAMILY MEDICINE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOLA ELEMUREN MD.PA
Authorized official
DR. IYABO BOLA ELEMUREN M.D (OWNER)
(254) 699-8521
Entity
Organization
Contact information
Practice address
740 S AMY LN, STE 101, HARKER HEIGHTS, TX 76548-1343
(254) 699-8521
(254) 699-8528
Mailing address
740 S AMY LN, STE 101, HARKER HEIGHTS, TX 76548-1343
(254) 699-8521
(254) 699-8528
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K4050
TX
363A00000X
Physician Assistant
PA01547
TX
Other
Enumeration date
09/05/2007
Last updated
01/10/2012
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