Mineola Medical Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MINEOLA MEDICAL CENTER PLLC

Practice address

415 W Kilpatrick St
Mineola, TX 75773-2032

Phone

(903) 569-2006

NPI assigned

Nov 1, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Aderemi Adewuyi, MDNPI 1760589303

Title

Medical Director

Phone

(214) 406-7240

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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

• Aderemi Adewuyi, M.D.

  • Internal Medicine Physician
  • Murphy, TX
  • NPI 1760589303
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1053955039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W KILPATRICK ST",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732032",
            "telephone_number": "903-569-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINEOLA MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "ADEWUYI",
        "authorized_official_first_name": "ADEREMI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "214-406-7240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Layne Miller, RD
• Mineola Counseling Services
• Mineola Dental PLLC
• Mineola Healthcare LLC
• Mineola Independent School District
• Mineola Nursing and Rehab Center
• Mineola Senior Living, LLC
• Anna Rachel Mitchell
• Afshan Mohammed, RD
• Patricia A Mone, PT

• Internal Medicine Physician in Mineola, TX
• Providers in Mineola, 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 Nov 1, 2019; 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.