Organization
FORT WORTH INTERNAL MEDICINE PA
Active
Organization
FORT WORTH INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEBOLA SULAIMAN OLATUNJI MD (DIRECTOR)
(817) 386-9818
Entity
Organization
Contact information
Practice address
654 SAINT LOUIS AVE, FORT WORTH, TX 76104-3358
(817) 386-9818
Mailing address
654 SAINT LOUIS AVE, FORT WORTH, TX 76104-3358
(817) 386-9818
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L9833
TX
Other
Enumeration date
02/08/2007
Last updated
06/17/2015
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