Agoro, Adesubomi
Agoro, Adesubomi is an individual health care provider with primary practice located at 1100 Pennsylvania Ave , Fort Worth TX 76104-2120. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Agoro, Adesubomi can be contacted via phone (817) 763-5550.Contact Information
Primary practice address
1100 Pennsylvania Ave
Fort Worth TX 76104-2120
Phone: (817) 763-5550
Fax: (817) 870-1280
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | K2394 | Texas |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | K2394 | Texas |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | K2394 | Texas |
Profile Details
| NPI number | 1073583076 |
|---|---|
| LBN Legal business name | Agoro, Adesubomi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Mar 2nd, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073583076 | NPPES |
| Texas | MEDICAID | 045359901 |
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