| Kusi Fordjour M.d Pa | |
|
2505 Bolton Boone Dr #101 Desoto TX 75115-2013 | |
| (972) 264-9100 | |
| (972) 283-9104 |
| Full Name | Kusi Fordjour M.d Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2505 Bolton Boone Dr, Desoto, Texas |
| Authorized Official Name and Position | Kusi Fordjour (PRESIDENT AND CEO) |
| Authorized Official Contact | 2146733934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kusi Fordjour M.d Pa Po Box 93597 Southlake TX 76092-0115 Ph: (972) 264-9100 | Kusi Fordjour M.d Pa 2505 Bolton Boone Dr #101 Desoto TX 75115-2013 Ph: (972) 264-9100 |
| NPI Number | 1811101348 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 05/25/2011 |
| Medicare PECOS PAC ID | 7315921731 |
|---|---|
| Medicare Enrollment ID | O20040615000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811101348 | NPI | - | NPPES |
| 0098MT | Other | TX | BCBS |
| 173380001 | Medicaid | TX | |
| L0177 | Other | TX | LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L0177 (Texas) | Primary |
| Provider Name | Kusi Fordjour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780623074 PECOS PAC ID: 7113913245 Enrollment ID: I20040422001631 |
| Provider Name | Oliva G Pacana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992014039 PECOS PAC ID: 8628231685 Enrollment ID: I20120531000604 |
| Provider Name | Deborah Larbie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356717235 PECOS PAC ID: 1355364902 Enrollment ID: I20150915000098 |
Nallu R Reddy Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2727 Bolton Boone Dr, 111, Desoto, TX 75115 Phone: 972-780-0357 Fax: 972-780-7829 | |
Elite Np Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 412 E Pleasant Run Rd Ste B, Desoto, TX 75115 Phone: 682-325-9617 | |
Compassionate Family Health Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2727 Bolton Boone Dr Ste 110, Desoto, TX 75115 Phone: 972-685-2494 Fax: 972-739-2436 | |
Priceless Beauty Spa,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1021 June Bug Ln, Desoto, TX 75115 Phone: 972-358-8109 Fax: 872-888-0554 | |
Ricardo Quezada Real Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 951 York Dr Ste 103, Desoto, TX 75115 Phone: 972-866-4311 Fax: 972-866-4312 | |
Mahesh Kottapalli, M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2727 Bolton Boone Dr, Suite109, Desoto, TX 75115 Phone: 972-283-2370 Fax: 972-296-0311 | |
Southwest Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1815 N Hampton Rd, Desoto, TX 75115 Phone: 972-709-2828 |