Mesquite Medical Group, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MESQUITE MEDICAL GROUP, LLC

Practice address

5115 N Galloway Ave Ste 203
Mesquite, TX 75150-7535

Phone

(214) 660-8554

Fax

(214) 660-8634

NPI assigned

Nov 1, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Adewumi Adewale Bakare, DMS, PA

Title

Ceo

Phone

(214) 660-8554

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• PA Housecalls Doing business as

Locations

Practitioners 1

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

• Deandre A Brown, MD

  • Internal Medicine Physician
  • Grand Prairie, TX
  • NPI 1932300779
  NPD

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1134429509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N GALLOWAY AVE STE 203",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507535",
            "telephone_number": "214-660-8554",
            "fax_number": "214-660-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N GALLOWAY AVE STE 203",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507535",
            "telephone_number": "214-660-8554",
            "fax_number": "214-660-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESQUITE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "BAKARE",
        "authorized_official_first_name": "ADEWUMI",
        "authorized_official_middle_name": "ADEWALE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-660-8554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMS, PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0064",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "N0064",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283257801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "TXB125532",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PA Housecalls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mesquite Independent School District
• Mesquite Injury Rehab
• Mesquite Internal Medicine
• Mesquite Medical & Surgical Clinic P.a.
• Mesquite Medical Clinic
• Mesquite Neurology Clinic PA
• Mesquite Nursing Center, L.P.
• Mesquite Pharmacy LLC
• Mesquite Pharmacy RX LLC
• Mesquite Pharmacy RX LLC

• Clinic/Center in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.