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General NPI Number Information
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NPI Number | 1366585705
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Entity Type | Organization
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Legal Business Name | OLUTOSIN ADEESO
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 06/14/2008
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Provider Practice Location Address
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Address Line | 13999 GOLDMARK DR SUITE 401
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City | DALLAS
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State | TX
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Zip | 75240-4234
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Country | US
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Telephone | 972-664-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 2316 SHELDON DR
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City | MCKINNEY
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State | TX
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Zip | 75070-2443
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Country | US
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Telephone | 972-664-1300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. OLUTOSIN JOHNSON ADEESO
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Credential |
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Telephone | 972-664-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0065283
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License Number State | TX
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