Provider Demographics
NPI:1538213517
Name:FIRST CARE MEDICAL CENTER
Entity type:Organization
Organization Name:FIRST CARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IKENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADUGBA
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:940-384-1809
Mailing Address - Street 1:400 S CARROLL BLVD STE 2000
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-7438
Mailing Address - Country:US
Mailing Address - Phone:940-384-1809
Mailing Address - Fax:940-384-7744
Practice Address - Street 1:400 S CARROLL BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7438
Practice Address - Country:US
Practice Address - Phone:940-384-1809
Practice Address - Fax:940-384-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty