| Community Medical Clinic | |
|
708 W Spring Valley Rd Richardson TX 75080-7216 | |
| (214) 570-9400 | |
| (972) 792-7246 |
| Full Name | Community Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 708 W Spring Valley Rd, Richardson, Texas |
| Authorized Official Name and Position | Lydia Oluwatoyin Njamfa (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2145709400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Clinic 708 W Spring Valley Rd Richardson TX 75080-7216 Ph: (214) 570-9400 | Community Medical Clinic 708 W Spring Valley Rd Richardson TX 75080-7216 Ph: (214) 570-9400 |
| NPI Number | 1922010479 |
|---|---|
| Provider Enumeration Date | 08/13/2006 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 7315090545 |
|---|---|
| Medicare Enrollment ID | O20090805000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922010479 | NPI | - | NPPES |
| 10017340 | Other | TX | AMERIGROUP |
| 1703118-02 | Medicaid | TX | |
| 1703118-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L0884 (Texas) | Primary |
| Provider Name | Lydia O Njamfa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619989142 PECOS PAC ID: 4587601364 Enrollment ID: I20050413000521 |
| Provider Name | Hussem A Farrach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548358765 PECOS PAC ID: 4587550850 Enrollment ID: I20130130000369 |
| Provider Name | Erika Pantoja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457840746 PECOS PAC ID: 2668707407 Enrollment ID: I20190716001571 |
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