| Medi- Elite, PC | |
|
2721 Central Dr Bedford TX 76021-4810 | |
| (682) 703-8881 | |
| (706) 203-3259 |
| Full Name | Medi- Elite, PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 2721 Central Dr, Bedford, Texas |
| Authorized Official Name and Position | Mahalia L Jackson-butler (CEO) |
| Authorized Official Contact | 2142772243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medi- Elite, PC 4621 S Cooper St Ste 131-717 Arlington TX 76017-5866 Ph: (214) 277-2243 | Medi- Elite, PC 2721 Central Dr Bedford TX 76021-4810 Ph: (682) 703-8881 |
| NPI Number | 1528330792 |
|---|---|
| Provider Enumeration Date | 02/03/2012 |
| Last Update Date | 11/24/2024 |
| Certification Date | 11/24/2024 |
| Medicare PECOS PAC ID | 0648594309 |
|---|---|
| Medicare Enrollment ID | O20150129000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528330792 | NPI | - | NPPES |
| Provider Name | Mahalia L Jackson Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063669893 PECOS PAC ID: 3375601339 Enrollment ID: I20090305000738 |
| Provider Name | Shelley Renee Reed-pouncy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588470272 PECOS PAC ID: 1254249865 Enrollment ID: I20250425000047 |
| Provider Name | Peris B Momanyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194533356 PECOS PAC ID: 5799266417 Enrollment ID: I20260220002244 |
| Provider Name | Mariel Eloisa Yumul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780555201 PECOS PAC ID: 0547735656 Enrollment ID: I20260407000957 |
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