| Opgt | |
|
3300 S Fm 1788 Midland TX 79706-2601 | |
| (337) 210-4477 | |
| (432) 561-8071 |
| Full Name | Opgt |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3300 S Fm 1788, Midland, Texas |
| Authorized Official Name and Position | Laura F. Tarantino (CEO) |
| Authorized Official Contact | 9722655449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opgt 3905 Hedgcoxe Rd Unit 250249 Plano TX 75025-0840 Ph: (972) 464-0022 | Opgt 3300 S Fm 1788 Midland TX 79706-2601 Ph: (337) 210-4477 |
| NPI Number | 1366864951 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 06/01/2023 |
| Certification Date | 06/01/2023 |
| Medicare PECOS PAC ID | 6901029206 |
|---|---|
| Medicare Enrollment ID | O20140513001596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366864951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Marsha K Wheatley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679683122 PECOS PAC ID: 8022906700 Enrollment ID: I20040304001366 |
| Provider Name | Kochuparampil T Varghese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528075686 PECOS PAC ID: 1355494360 Enrollment ID: I20090807000390 |
| Provider Name | Duane C Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093708687 PECOS PAC ID: 5597834952 Enrollment ID: I20091201000217 |
| Provider Name | Sergio Silva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255341061 PECOS PAC ID: 5991980914 Enrollment ID: I20110505000833 |
| Provider Name | Dolores H Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831595099 PECOS PAC ID: 4284950965 Enrollment ID: I20150225000737 |
| Provider Name | John H Casada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275640252 PECOS PAC ID: 9739245226 Enrollment ID: I20150409001005 |
| Provider Name | Olusegun A Bello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043395486 PECOS PAC ID: 9739471301 Enrollment ID: I20160630001537 |
| Provider Name | Kimberly De'anne Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427590926 PECOS PAC ID: 1759600984 Enrollment ID: I20170111000306 |
| Provider Name | James E Butler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104118918 PECOS PAC ID: 5799067237 Enrollment ID: I20170118002409 |
| Provider Name | Candes Dotson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861713703 PECOS PAC ID: 3577720267 Enrollment ID: I20170824000779 |
| Provider Name | Folasade Olayiwole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679084610 PECOS PAC ID: 6305104829 Enrollment ID: I20171211001116 |
| Provider Name | Latarsha Waltronia Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376073072 PECOS PAC ID: 9032474283 Enrollment ID: I20180517002220 |
| Provider Name | Gail I Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649399452 PECOS PAC ID: 6709111248 Enrollment ID: I20190705000765 |
| Provider Name | Laurie S Stiger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942630959 PECOS PAC ID: 9436480910 Enrollment ID: I20191015000721 |
| Provider Name | Olayemi Cynthia Akindele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801245998 PECOS PAC ID: 6608201454 Enrollment ID: I20200124000652 |
| Provider Name | Princess D Eghianruwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477161164 PECOS PAC ID: 1052736691 Enrollment ID: I20200730000872 |
| Provider Name | Gina Pollina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396216289 PECOS PAC ID: 7618308248 Enrollment ID: I20200803002576 |
| Provider Name | Kedrick J St Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821693011 PECOS PAC ID: 9335553486 Enrollment ID: I20210201000798 |
| Provider Name | Donavan Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902489305 PECOS PAC ID: 1658777321 Enrollment ID: I20210903000556 |
| Provider Name | Nikki M Nazworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992068084 PECOS PAC ID: 2466849922 Enrollment ID: I20220502000767 |
| Provider Name | Daniel Oyewusi Oyewole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386257814 PECOS PAC ID: 5799156667 Enrollment ID: I20230201001485 |
| Provider Name | Misti Dawn Bryant Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306595020 PECOS PAC ID: 4880066950 Enrollment ID: I20230220000037 |
| Provider Name | Friday Chidozie Nwabuisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831807734 PECOS PAC ID: 1557735966 Enrollment ID: I20230327002499 |
| Provider Name | Cara Ramsey Mcdermott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073195343 PECOS PAC ID: 9234530361 Enrollment ID: I20230915001936 |
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