| Ada Adult And Children Family Clinic Llc | |
|
3416 W Wall St Midland TX 79701-6710 | |
| (432) 400-3066 | |
| Not Available |
| Full Name | Ada Adult And Children Family Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3416 W Wall St, Midland, Texas |
| Authorized Official Name and Position | Olanrewaju Samuel Ayileka (CLINIC MANAGER) |
| Authorized Official Contact | 4324003066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ada Adult And Children Family Clinic Llc Po Box 4534 Midland TX 79704-4534 Ph: (432) 400-3066 | Ada Adult And Children Family Clinic Llc 3416 W Wall St Midland TX 79701-6710 Ph: (432) 400-3066 |
| NPI Number | 1578191292 |
|---|---|
| Provider Enumeration Date | 03/29/2020 |
| Last Update Date | 02/05/2024 |
| Medicare PECOS PAC ID | 9830528934 |
|---|---|
| Medicare Enrollment ID | O20200409003358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578191292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Abiodun Okin-ayileka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922328079 PECOS PAC ID: 5597980086 Enrollment ID: I20140625000367 |
| Provider Name | Brenda Campos-ilesanmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740807304 PECOS PAC ID: 6305261405 Enrollment ID: I20200806002139 |
| Provider Name | Hien Bich Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629379045 PECOS PAC ID: 2668646423 Enrollment ID: I20240405002747 |
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