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General NPI Number Information
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NPI Number | 1083829527
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Entity Type | Organization
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Legal Business Name | KIFLE ADMASSU MD PA
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 06/26/2015
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Provider Practice Location Address
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Address Line | 305 HAWKS RIDGE TRL
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8213
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Country | US
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Telephone | 817-960-6648
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Fax | 817-960-6649
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Provider Business Mailing Address
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Address Line | 305 HAWKS RIDGE TRL
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8213
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Country | US
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Telephone | 817-960-6648
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Fax | 817-960-6649
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | KIFLE ADMASSU
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Credential | MD
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Telephone | 817-960-6648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M1448
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License Number State | TX
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