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1316233505

NPI Code Detail

MEDICARE: DR. JILALU ASMERA KELBE MD

MEDICARE: DR. JILALU ASMERA KELBE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD446348	PA
2	207RP1001X	Pulmonary Disease Physician	R3120	TX
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	R3120	TX

General Provider Information

NPI Number	:	1316233505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILALU ASMERA KELBE MD

Provider Business Mailing Address
First Line	:	3600 GASTON AVE STE 960
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1909
Country	:	US
Telephone Number	:	469-800-7686
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 GASTON AVE STE 960
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1909
Country	:	US
Telephone Number	:	469-800-7686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2011
Last Update Date	:	07/21/2022

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Directions to “ DR. JILALU ASMERA KELBE MD” Practice Location

Language	Start Address	Practice Location

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