Provider Demographics
NPI:1982179974
Name:ANADEL PROFESSIONALS LLC
Entity Type:Organization
Organization Name:ANADEL PROFESSIONALS LLC
Other - Org Name:ANADEL CENTER FOR FOOT & ANKLE RECONSTRUCTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TORTISENERE
Authorized Official - Middle Name:BLESSING
Authorized Official - Last Name:ONOSODE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-864-7353
Mailing Address - Street 1:3245 MAIN ST STE 235-308
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3140 LEGACY DR STE 330
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9383
Practice Address - Country:US
Practice Address - Phone:972-864-7353
Practice Address - Fax:972-864-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty