Organization
ABA MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEOLA ANTHONY AMUSAN M.D., (INTERNAL MEDICINE DOCTOR)
(469) 200-4118
Entity
Organization
Contact information
Practice address
502 E HIGH ST, TERRELL, TX 75160-2836
(469) 200-4115
(469) 200-4118
Mailing address
502 E HIGH ST, TERRELL, TX 75160-2836
(469) 200-4115
(469) 200-4118
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
L1515
TX
Other
Enumeration date
08/08/2011
Last updated
08/08/2011
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