Prima Medical Group PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PRIMA MEDICAL GROUP PLLC

Practice address

4800 Sugar Grove Blvd Ste 250
Stafford, TX 77477-2639

Phone

(832) 554-6773

NPI assigned

Jul 9, 2025

Last updated

Jul 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Iyabo OmidiwuraNPI 1750864799

Title

Enrollment Manager

Phone

(832) 554-6773

Specialties & licenses 2

Addresses

Other names 1

• Prima Medical Group Former legal business name

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, and the practitioner matching its NPPES authorized official.

• Iyabo Mercy Omidiwura, APRN-CNP

  • Nurse Practitioner
  • Stafford, TX
  • NPI 1750864799
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1801787817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SUGAR GROVE BLVD STE 250",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772639",
            "telephone_number": "832-554-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SUGAR GROVE BLVD STE 250",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772639",
            "telephone_number": "832-554-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "OMIDIWURA",
        "authorized_official_first_name": "IYABO",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "832-554-6773"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prima Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Precisionmed Pharmacy
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• Pri-Med Family Clinic & Wellness Center
• Latanya K Price
• Alex D Priester, LCDC
• Prime Occ, PLLC
• Primic Palliative Hospice Care Inc
• Primus EMS Inc
• Priority Ambulance Transfer LLC
• Judd Michael Prioux, LVN

• General Practice Physician in Stafford, TX
• Providers in Stafford, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.