Provider Demographics
NPI:1467090050
Name:EDROPA FAMILY MEDICINE CLINIC
Entity Type:Organization
Organization Name:EDROPA FAMILY MEDICINE CLINIC
Other - Org Name:EVEXIA FAMILY MEDICINE CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:ADOMAA
Authorized Official - Last Name:ASAFO-AGYEI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-529-9041
Mailing Address - Street 1:339 REDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-3240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:429 E INTERSTATE 30 STE 114
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4097
Practice Address - Country:US
Practice Address - Phone:972-795-3292
Practice Address - Fax:972-767-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-14
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care