Organization
MICHAEL E ESEDEBE MDPA
Active
Parent organization
MICHAEL E ESEDEBE MDPA
Other names
AUDELIA MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL E ESEDEBE MDPA
Authorized official
DR. MICHAEL EMEKA ESEDEBE MD (MEDICAL DIRECTOR)
(214) 336-9559
Entity
Organization
Contact information
Practice address
11617 N CENTRAL EXPY, SUITE 240, DALLAS, TX 75243-3800
(214) 553-1516
(214) 553-1519
Mailing address
11617 N CENTRAL EXPY, SUITE 240, DALLAS, TX 75243-3800
(214) 553-1516
(214) 553-1519
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
L0155
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047474404
—
TX
Enumeration date
12/18/2006
Last updated
02/01/2012
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