| Adjetey K Lomo Pa Inc | |
|
601 Wayside Dr Ste B Houston TX 77011-3614 | |
| (713) 921-1200 | |
| (713) 921-1201 |
| Full Name | Adjetey K Lomo Pa Inc |
|---|---|
| Speciality | General Practice |
| Location | 601 Wayside Dr Ste B, Houston, Texas |
| Authorized Official Name and Position | Adjetey K Lomo (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7139211200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adjetey K Lomo Pa Inc 601 Wayside Dr Ste B Houston TX 77011-3614 Ph: (713) 921-1200 | Adjetey K Lomo Pa Inc 601 Wayside Dr Ste B Houston TX 77011-3614 Ph: (713) 921-1200 |
| NPI Number | 1649431875 |
|---|---|
| Provider Enumeration Date | 06/20/2008 |
| Last Update Date | 12/01/2014 |
| Medicare PECOS PAC ID | 5890712970 |
|---|---|
| Medicare Enrollment ID | O20051027001024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649431875 | NPI | - | NPPES |
| 323066602 | Medicaid | TX | |
| 323066601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | J7056 (Texas) | Primary |
| Provider Name | Adjetey K Lomo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134174105 PECOS PAC ID: 6800886458 Enrollment ID: I20040514001036 |
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