| Odette Louise Campbell Md Pa | |
|
5072 W Plano Pkwy Ste 220 Plano TX 75093-4475 | |
| (469) 671-0900 | |
| (972) 695-8827 |
| Full Name | Odette Louise Campbell Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 5072 W Plano Pkwy Ste 220, Plano, Texas |
| Authorized Official Name and Position | Odette Louise Campbell (PRESIDENT) |
| Authorized Official Contact | 9725332716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Odette Louise Campbell Md Pa 5072 W Plano Pkwy Ste 220 Plano TX 75093-4475 Ph: (972) 533-2716 | Odette Louise Campbell Md Pa 5072 W Plano Pkwy Ste 220 Plano TX 75093-4475 Ph: (469) 671-0900 |
| NPI Number | 1366750325 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 08/19/2019 |
| Medicare PECOS PAC ID | 9335301829 |
|---|---|
| Medicare Enrollment ID | O20120430000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366750325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | H9609 (Texas) | Primary |
| 2085R0001X | Radiology - Radiation Oncology | H9609 (Texas) | Secondary |
| Provider Name | Khalillah S Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972521417 PECOS PAC ID: 1951350560 Enrollment ID: I20050120000455 |
| Provider Name | Odette L Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114989092 PECOS PAC ID: 3476576844 Enrollment ID: I20060111000933 |
| Provider Name | Martha A Breckenridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285792598 PECOS PAC ID: 4486669447 Enrollment ID: I20060213000173 |
| Provider Name | Immaculata Eme Inyang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245504588 PECOS PAC ID: 8022270883 Enrollment ID: I20120424000665 |
| Provider Name | Gaudensia Awuor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952664328 PECOS PAC ID: 8628225166 Enrollment ID: I20120905000783 |
| Provider Name | Ket Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588911705 PECOS PAC ID: 4789833609 Enrollment ID: I20121009000153 |
| Provider Name | Mario G Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669591871 PECOS PAC ID: 5496840530 Enrollment ID: I20140303000508 |
| Provider Name | Hassanatu Michael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861892333 PECOS PAC ID: 3971690694 Enrollment ID: I20150108002284 |
| Provider Name | Sylvain Nitcheu Tientcheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346632239 PECOS PAC ID: 8729306733 Enrollment ID: I20150422001623 |
| Provider Name | Charles O Ejiofor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477951267 PECOS PAC ID: 3971824129 Enrollment ID: I20150601000744 |
| Provider Name | Georgena Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346587680 PECOS PAC ID: 5193028710 Enrollment ID: I20160114001454 |
| Provider Name | Ethelbert O Odo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710402698 PECOS PAC ID: 8729036561 Enrollment ID: I20180201000549 |
| Provider Name | Enobong C. Udo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124518253 PECOS PAC ID: 3072862242 Enrollment ID: I20180821002634 |
| Provider Name | Joy Ihuoma Utokanandu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457851487 PECOS PAC ID: 7719236553 Enrollment ID: I20180828000445 |
| Provider Name | Yetunde Tolulope Oladosu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841781770 PECOS PAC ID: 8224388616 Enrollment ID: I20180905003407 |
| Provider Name | Kashaelyn Lanieca Hollins Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912493230 PECOS PAC ID: 9931446440 Enrollment ID: I20190122002769 |
| Provider Name | Deborah C Kerner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811470982 PECOS PAC ID: 2668714635 Enrollment ID: I20190424000693 |
| Provider Name | Bih R Numfor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457803520 PECOS PAC ID: 2466735956 Enrollment ID: I20190627002562 |
| Provider Name | Roseline A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538645510 PECOS PAC ID: 4385970813 Enrollment ID: I20190722002721 |
| Provider Name | David Michael Mclendon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548787948 PECOS PAC ID: 3971839937 Enrollment ID: I20190729002329 |
| Provider Name | Farouk Talakshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316233000 PECOS PAC ID: 4587956420 Enrollment ID: I20191115001840 |
| Provider Name | Diana C Kipchilat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245704683 PECOS PAC ID: 4587099171 Enrollment ID: I20200108000826 |
| Provider Name | Uchenna L Nwedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336676980 PECOS PAC ID: 9830524826 Enrollment ID: I20200122000587 |
| Provider Name | Sandra I Abusomwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023637303 PECOS PAC ID: 8729061825 Enrollment ID: I20200609001302 |
| Provider Name | Zaid Qaraghan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144634809 PECOS PAC ID: 3577782093 Enrollment ID: I20210908002736 |
| Provider Name | Evelyn C.k Maangi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457958712 PECOS PAC ID: 2668859620 Enrollment ID: I20220727000175 |
| Provider Name | Mayssara Jubori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518317148 PECOS PAC ID: 7214267616 Enrollment ID: I20220817000189 |
| Provider Name | Georgina Aka Fomenky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154943686 PECOS PAC ID: 6507240637 Enrollment ID: I20220908001649 |
| Provider Name | Roselio Perez Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043780513 PECOS PAC ID: 0941699755 Enrollment ID: I20230816001878 |
| Provider Name | Lydia F Mwesigwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528752649 PECOS PAC ID: 9537078373 Enrollment ID: I20240226001044 |
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