Kusi Fordjour M.D PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L0177 Issued in TX

Legal business name

KUSI FORDJOUR M.D PA

Practice address

2505 Bolton Boone Dr
#101
Desoto, TX 75115-2013

Phone

(972) 264-9100

Fax

(972) 283-9104

NPI assigned

May 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kusi Fordjour, MDNPI 1780623074

Title

President and Ceo

Phone

(214) 673-3934

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kusi Fordjour, MD

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1780623074
  Medicare reassignment NPD Authorized official
• Deborah Densua Larbie, FNP

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1356717235
  Medicare reassignment NPD
• Angelei Guzman Mercado, FNP

  • Nurse Practitioner
  • San Antonio, TX
  • NPI 1942830708
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1811101348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93597",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920115",
            "telephone_number": "972-264-9100",
            "fax_number": "972-283-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 BOLTON BOONE DR",
            "address_2": "#101",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152013",
            "telephone_number": "972-264-9100",
            "fax_number": "972-283-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUSI FORDJOUR M.D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "FORDJOUR",
        "authorized_official_first_name": "KUSI",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "214-673-3934",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0098MT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173380001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "L0177",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Praveen G Kottackal- Varkey, DDS
• Mahesh B Kottapalli, MD
• Kroger Texas L P
• Ksa Addiction Treatment LLC
• Simone Kurney, PHLEBOTOMIST LICENSE
• Haley H Kutch, DPT
• Ladair Integrated Health PLLC
• Shemika Lafitte, HAIR LOSS SPECIALIST
• Louise Lamarre, M.D.
• Vishu Lammata, M.D.

• Internal Medicine Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.