Active NPI
Michael E Esedebe Mdpa
- Clinic/Center
- Dallas, TX
National Provider Identifier
1740343177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- L0155
- Legal business name
- MICHAEL E ESEDEBE MDPA
- Doing business as
- AUDELIA MEDICAL CENTER
- Practice address
- 11617 N Central Expy
Suite 240
Dallas, TX 75243-3800 - Phone
- (214) 553-1516
- Fax
- (214) 553-1519
- NPI assigned
- Dec 18, 2006
- Organization subpart
- Yes
- Parent organization
- MICHAEL E ESEDEBE MDPA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Emeka Esedebe, MD
- Title
- Medical Director
- Phone
- (214) 336-9559
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | L0155 | TX | Primary |
Addresses
Primary practice location
11617 N Central Expy
Suite 240
Dallas, TX 75243-3800
Mailing address
11617 N Central Expy
Suite 240
Dallas, TX 75243-3800
Phone (214) 553-1516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047474404 | Medicaid | TX |
Other names 1
- AUDELIA MEDICAL CENTER
National Provider Directory
National Provider Directory- Part of
- Michael E Esedebe Mdpa
Locations
11617 N Central Expy
Ste 240
Dallas, TX 75243
Phone (214) 553-1516
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Dallas, TX
- NPI 1952410037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1328054400000",
"number": "1740343177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11617 N CENTRAL EXPY",
"address_2": "SUITE 240",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433800",
"telephone_number": "214-553-1516",
"fax_number": "214-553-1519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11617 N CENTRAL EXPY",
"address_2": "SUITE 240",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433800",
"telephone_number": "214-553-1516",
"fax_number": "214-553-1519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHAEL E ESEDEBE MDPA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MICHAEL E ESEDEBE MDPA",
"enumeration_date": "2006-12-18",
"last_updated": "2012-02-01",
"status": "A",
"authorized_official_last_name": "ESEDEBE",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "EMEKA",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "214-336-9559",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "TX",
"license": "L0155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "047474404",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "AUDELIA MEDICAL CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.