Provider Demographics
NPI:1659695534
Name:ADEESO, CAROLINE O
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:O
Last Name:ADEESO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 SHELDON DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2443
Mailing Address - Country:US
Mailing Address - Phone:214-236-5170
Mailing Address - Fax:214-544-7204
Practice Address - Street 1:2316 SHELDON DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2443
Practice Address - Country:US
Practice Address - Phone:214-236-5170
Practice Address - Fax:214-544-7204
Is Sole Proprietor?:No
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator