Medbak Healthcare Services, PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA06380 Issued in TX

Legal business name

MEDBAK HEALTHCARE SERVICES, PLLC

Practice address

1130 Beachview St
Ste 110
Dallas, TX 75218-3700

Phone

(214) 516-1495

Fax

(214) 660-8634

NPI assigned

Jul 15, 2016

Last updated

Jul 15, 2016By 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

Adewumi Bakare, PA

Title

Ceo

Phone

(214) 516-1495

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1952754806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST",
            "address_2": "STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183700",
            "telephone_number": "214-516-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST",
            "address_2": "STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183700",
            "telephone_number": "214-516-1495",
            "fax_number": "214-660-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDBAK HEALTHCARE SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "BAKARE",
        "authorized_official_first_name": "ADEWUMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-516-1495",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Dallas, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.