| Addis Family Clinic Professional Llc | |
|
2135 Buckingham Rd Richardson TX 75081-5459 | |
| (469) 835-2836 | |
| Not Available |
| Full Name | Addis Family Clinic Professional Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2135 Buckingham Rd, Richardson, Texas |
| Authorized Official Name and Position | Bekele Olbamo (OWNER) |
| Authorized Official Contact | 4698352836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Addis Family Clinic Professional Llc 8301 Lighthouse Dr Rowlett TX 75089-7882 Ph: (469) 835-2836 | Addis Family Clinic Professional Llc 2135 Buckingham Rd Richardson TX 75081-5459 Ph: (469) 835-2836 |
| NPI Number | 1558720383 |
|---|---|
| Provider Enumeration Date | 02/22/2016 |
| Last Update Date | 06/08/2016 |
| Medicare PECOS PAC ID | 3274828249 |
|---|---|
| Medicare Enrollment ID | O20160830001506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558720383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bekele C Olbamo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053554360 PECOS PAC ID: 3072702877 Enrollment ID: I20110110000660 |
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