MEDICARE: INWOOD MEDICAL CLINIC INC.

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1679043723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INWOOD MEDICAL CLINIC INC.

Provider Business Mailing Address
First Line	:	2916 INWOOD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2916 INWOOD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7518
Country	:	US
Telephone Number	:	214-570-0006
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	ADETUNJI OSHUN
Credential	:	PA
Telephone Number	:	347-845-1444

Provider Enumeration Date	:	12/03/2018
Last Update Date	:	12/03/2018

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