Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | J7056 | TX |
N | 2080A0000X | Adolescent Medicine | J7056 | TX |
N | 208D00000X | General Practice Physician | J7056 | TX |
NPI | 1134174105 |
---|---|
Provider Name | Dr. Adjetey K Lomo |
First Address | Houston, TX 77011-3614 |
Second Address | Houston, TX 77011-3614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 01/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138038816 | (05) | TX |
E55253 | (02) | TX |