Provider Demographics
NPI:1972282374
Name:ADHANA, SELEMON AFERA
Entity Type:Individual
Prefix:
First Name:SELEMON
Middle Name:AFERA
Last Name:ADHANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 HUNT DR APT 4108
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-3263
Mailing Address - Country:US
Mailing Address - Phone:346-719-3303
Mailing Address - Fax:
Practice Address - Street 1:4229 HUNT DR APT 4108
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-3263
Practice Address - Country:US
Practice Address - Phone:346-719-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)