| Avid Healthcare Services Pa | |
|
604 N Rockwall Ave Terrell TX 75160-2117 | |
| (972) 522-8524 | |
| Not Available |
| Full Name | Avid Healthcare Services Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 604 N Rockwall Ave, Terrell, Texas |
| Authorized Official Name and Position | David Okumbor (PRESIDENT) |
| Authorized Official Contact | 2146753859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avid Healthcare Services Pa 18 Kestrel Ct Heath TX 75032-2043 Ph: (214) 675-3859 | Avid Healthcare Services Pa 604 N Rockwall Ave Terrell TX 75160-2117 Ph: (972) 522-8524 |
| NPI Number | 1790248987 |
|---|---|
| Provider Enumeration Date | 04/13/2019 |
| Last Update Date | 04/13/2019 |
| Medicare PECOS PAC ID | 4789927112 |
|---|---|
| Medicare Enrollment ID | O20190528001098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790248987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
| Provider Name | David O Okumbor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164616199 PECOS PAC ID: 8921164773 Enrollment ID: I20090304000195 |
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