Avid Healthcare Services PA
Organization Active NPI Health Service Clinic/Center · Terrell, TX
NPI 1790248987 · NPPES record last updated Apr 13, 2019
Key facts
- NPI
- 1790248987
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- AVID HEALTHCARE SERVICES PA
- Practice address
- 604 N Rockwall Ave
Terrell, TX 75160-2117 - Phone
- (972) 522-8524
- NPI assigned
- Apr 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. David Okumbor, MD
- Title
- President
- Phone
- (214) 675-3859
Practitioners 2
-
David Osagie Okumbor, M.D
-
Oluwafisayo Oni, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190528001098 | TX | Part B Supplier - Clinic/Group Practice | 4789927112 |
Receives reassigned benefits from 1 practitioner Practice locations: Terrell, TX |
National Provider Directory
Locations
2300 Marie Curie Dr
#5
Garland, TX 75042
Phone (972) 487-5309
604 N Rockwall Ave
Terrell, TX 75160
Phone (972) 522-8524
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes | ||
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
604 N Rockwall Ave
Terrell, TX 75160-2117
Mailing address
18 Kestrel CT
Heath, TX 75032-2043
Phone (214) 675-3859
Other providers in Terrell, TX
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- Antoinette Titus
- Arboretum Home Care LLC
- Levery Arion
- Jacob Arrington
- Baby Bliss Birthing Services
- Chrystal Shyette Baker
- Elisa Maria Baker
- Phillip B Balleza
- Balmoral, LTD
All providers in Terrell, TX · Health Service Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.