| Centerville Medical Center | |
|
1015 W Centerville Rd Ste 118 Garland TX 75041-5929 | |
| (972) 485-4440 | |
| (972) 807-6035 |
| Full Name | Centerville Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1015 W Centerville Rd Ste 118, Garland, Texas |
| Authorized Official Name and Position | Chukwuma Chimezie Osuagwu (PRESIDENT) |
| Authorized Official Contact | 2147661955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerville Medical Center 1302 Kent Brown Rd Garland TX 75044-5218 Ph: (214) 766-1955 | Centerville Medical Center 1015 W Centerville Rd Ste 118 Garland TX 75041-5929 Ph: (972) 485-4440 |
| NPI Number | 1821410523 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 11/16/2020 |
| Medicare PECOS PAC ID | 0648494849 |
|---|---|
| Medicare Enrollment ID | O20140609001911 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821410523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M4412 (Texas) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Chukwuma Osuagwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487748661 PECOS PAC ID: 6507930112 Enrollment ID: I20101213001152 |
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