Dr Angela Wallace Fadahunsi, MD is a medicare enrolled "Allergy & Immunology" physician in Wylie, Texas. Her current practice location is
611 S Highway 78 Ste 102, Wylie, Texas. You can reach out to her office (for appointments etc.) via phone at
(972) 954-9826.
Dr Angela Wallace Fadahunsi is licensed to practice in Texas (license number R5721) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780028951.
Physician's Profile
| Full Name | Dr Angela Wallace Fadahunsi |
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| Gender | Female |
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| Speciality | Allergy & Immunology |
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| Location | 611 S Highway 78 Ste 102, Wylie, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780028951
- Provider Enumeration Date: 04/18/2013
- Last Update Date: 06/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 1850531849
- Enrollment ID: I20181227001779
Medical Identifiers
Medical identifiers for Dr Angela Wallace Fadahunsi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780028951 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | R5721 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207K00000X | Allergy & Immunology | R5721 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Angela Wallace Fadahunsi allows following entities to bill medicare on her behalf.
| Entity Name | Healthtexas Provider Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760488936
PECOS PAC ID: 1355254210
Enrollment ID: O20040727001187 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Angela Wallace Fadahunsi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Angela Wallace Fadahunsi, MD
611 S Highway 78 Ste 102,
Wylie, TX 75098-4085
Ph: (972) 954-9826 | Dr Angela Wallace Fadahunsi, MD
611 S Highway 78 Ste 102,
Wylie, TX 75098
Ph: (972) 954-9826 |
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