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General NPI Number Information
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NPI Number | 1114320926
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Entity Type | Organization
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Legal Business Name | AQUILO MEDICAL HOME TEAM LLC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 1491 HEALTH CENTER PKWY
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City | YUKON
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State | OK
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Zip | 73099-6492
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Country | US
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Telephone | 405-990-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 HERITAGE DRIVE SUITE 110
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City | MCKINNEY
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State | TX
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Zip | 75069-3379
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Country | US
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Telephone | 855-860-2109
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CURTIS BROWN
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Credential | MD
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Telephone | 405-990-6654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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