Organization
2FFORDABLE FAMILY CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENEDICT O OLUSOLA MD (PRESIDENT)
(972) 820-6660
Entity
Organization
Contact information
Practice address
1927 E BELT LINE RD, STE 146, CARROLLTON, TX 75006-5821
(972) 820-6660
(972) 820-6631
Mailing address
1927 E BELT LINE RD, STE 146, CARROLLTON, TX 75006-5821
(972) 820-6660
(972) 820-6631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J7118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J7118
LICENCE
TX
Enumeration date
11/16/2010
Last updated
11/16/2010
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