Emergency Medical Doctors Services PLLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

K6196 Issued in TX

Legal business name

EMERGENCY MEDICAL DOCTORS SERVICES PLLC

Practice address

1201 S Allen Genoa Rd
Houston, TX 77587-4464

Phone

(713) 910-0000

Fax

(713) 910-0004

NPI assigned

Jan 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Agbolade O Odutayo, D.ONPI 1316992779

Title

Owner

Phone

(713) 910-0000

Specialties & licenses 3

Addresses

Other names 1

• Emergency Medical Doctors Services Urgent Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Agbolade O. Odutayo, D.O.

  • Emergency Medicine Physician
  • Cameron, TX
  • NPI 1316992779
  Medicare reassignment NPD Authorized official
• Abisoye Ifaseyi Odutayo, FNP-BC

  • Family Nurse Practitioner
  • South Houston, TX
  • NPI 1679911747
  Medicare reassignment NPD
• John Michael Bernard, P.A.

  • Physician Assistant
  • Laporte, TX
  • NPI 1144402959
  Medicare reassignment
• Valerie Claudia Siaha, FNP

  • Family Nurse Practitioner
  • South Houston, TX
  • NPI 1235740515
  NPD
• Radcliffe Myers, FNP-BC

  • Family Nurse Practitioner
  • South Houston, TX
  • NPI 1699135418
  NPD (past)

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1811227150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S ALLEN GENOA RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "775874464",
            "telephone_number": "713-910-0000",
            "fax_number": "713-910-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S ALLEN GENOA RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "775874464",
            "telephone_number": "713-910-0000",
            "fax_number": "713-910-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICAL DOCTORS SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-08",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "ODUTAYO",
        "authorized_official_first_name": "AGBOLADE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-910-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K6196",
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "K6196",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "TX",
            "license": "K6196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Medical Doctors Services Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emergency Ambulatory Services of TX.,PA
• Emergency Care of East Houston-Physicians, LLC
• Emergency Care of East Houston, LLC
• Emergency Health Centre at Willowbrook
• Emergency Healthcare Partners, LP
• Emergency Medical Group, LLC
• Emergency Medicine Physician of Houston
• Emergency Medicine Physicians of Texas
• Emergency Physicians Care of Plano, PLLC
• Emergency Physicians of Eldridge PLLC

• Emergency Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.