Healthcare Provider Details

I. General information

NPI: 1730720905
Provider Name (Legal Business Name): A&I MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 N ZARAGOZA RD STE X
EL PASO TX
79907-1862
US

IV. Provider business mailing address

1030 N ZARAGOZA RD STE X
EL PASO TX
79907-1862
US

V. Phone/Fax

Practice location:
  • Phone: 915-881-4155
  • Fax: 915-881-4172
Mailing address:
  • Phone: 915-881-4155
  • Fax: 915-881-4172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ADEKUNLE ADEDEJI
Title or Position: MD
Credential: MD
Phone: 915-881-4155