Mrs Edolo O Azenabor, PT in Grand Prairie, TX - Medicare Physical Therapist Provider

Mrs Edolo O Azenabor, PT is a medicare enrolled "Physical Therapist" provider in Grand Prairie, Texas. Her current practice location is 2306 Oak Ln Ste 206, Grand Prairie, Texas. You can reach out to her office (for appointments etc.) via phone at (972) 262-6400.

Mrs Edolo O Azenabor is licensed to practice in New Hampshire (license number 1907) 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 1033225750.

Contact Information

	Mrs Edolo O Azenabor, PT
	2306 Oak Ln Ste 206, Grand Prairie, TX 75051-8270
	(972) 262-6400
	(972) 262-6544

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Edolo O Azenabor
Gender	Female
Speciality	Physical Therapist
Location	2306 Oak Ln Ste 206, Grand Prairie, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033225750
Provider Enumeration Date: 08/23/2006
Last Update Date: 05/04/2020

Medicare PECOS Information:

PECOS PAC ID: 4880749910
Enrollment ID: I20200515000050

Medical Identifiers

Medical identifiers for Mrs Edolo O Azenabor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033225750	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	1907 (New Hampshire)	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. Mrs Edolo O Azenabor allows following entities to bill medicare on her behalf.

Provider Name	Prime Care Services Incorporated
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1326381401 PECOS PAC ID: 7416371737 Enrollment ID: O20210630000743

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. Mrs Edolo O Azenabor 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
Mrs Edolo O Azenabor, PT 2306 Oak Ln Ste 206, Grand Prairie, TX 75051-8270 Ph: (972) 262-6400	Mrs Edolo O Azenabor, PT 2306 Oak Ln Ste 206, Grand Prairie, TX 75051-8270 Ph: (972) 262-6400

Reviews and Comments

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Mrs Edolo O Azenabor, PT - Medicare Physical Therapist in Grand Prairie, TX