| Kifle Admassu Md Pa | |
|
305 Hawks Ridge Trl Colleyville TX 76034-8213 | |
| (817) 960-6648 | |
| (817) 960-6649 |
| Full Name | Kifle Admassu Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 305 Hawks Ridge Trl, Colleyville, Texas |
| Authorized Official Name and Position | Kifle Admassu (PRESIDENT AND CEO) |
| Authorized Official Contact | 8179606648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kifle Admassu Md Pa 305 Hawks Ridge Trl Colleyville TX 76034-8213 Ph: (817) 960-6648 | Kifle Admassu Md Pa 305 Hawks Ridge Trl Colleyville TX 76034-8213 Ph: (817) 960-6648 |
| NPI Number | 1083829527 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 06/26/2015 |
| Medicare PECOS PAC ID | 4082713029 |
|---|---|
| Medicare Enrollment ID | O20070615000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083829527 | NPI | - | NPPES |
| M1448 | Other | TX | LICENSE |
| 00X656 | Other | TX | NEW MEDICARE NUMBER |
| 612406 | Other | TX | OTHER MEDICARE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M1448 (Texas) | Primary |
| Provider Name | Kifle Admassu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184664401 PECOS PAC ID: 1153346721 Enrollment ID: I20051012000880 |
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