<unavail> in Terrell, TX - Medicare Nurse Practitioner

is a medicare enrolled primary clinic (Nurse Practitioner - Gerontology) in Terrell, Texas. The current practice location for is 904 W Moore Ave Ste B, Terrell, Texas. For appointments, you can reach them via phone at (972) 563-1475. The mailing address for is 904 W. Moore Ave., Suite B, Forney, Texas and phone number is (972) 563-1475.

is licensed to practice in Texas (license number ). The clinic also participates in the medicare program and its NPI number is 1093235046. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (972) 563-1475.

Contact Information


	904 W Moore Ave Ste B Terrell TX 75160-3004
	(972) 563-1475
	(972) 524-5132

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Nurse Practitioner
Location	904 W Moore Ave Ste B, Terrell, Texas
Authorized Official Name and Position	Michael O Idemudia (OWNER)
Authorized Official Contact	9725631475
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
904 W. Moore Ave. Suite B Forney TX 75126-0228 Ph: (972) 563-1475	904 W Moore Ave Ste B Terrell TX 75160-3004 Ph: (972) 563-1475

NPI Details:

NPI Number	1093235046
Provider Enumeration Date	06/21/2017
Last Update Date	12/19/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	6507137395
Medicare Enrollment ID	O20170814001146

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093235046	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	(* (Not Available))	Secondary
363LG0600X	Nurse Practitioner - Gerontology	(Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Michael O Idemudia
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1306391396 PECOS PAC ID: 3577844729 Enrollment ID: I20161229001283

Provider Name	Nkechi Renneth Idemudia
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1083169973 PECOS PAC ID: 0648547844 Enrollment ID: I20170907003156

Reviews and Comments

Nurse Practitioner in Terrell, TX

Priti B. Vyas; M.d. P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 W Nash St, Terrell, TX 75160 Phone: 972-563-6493
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Virginia St, Terrell, TX 75160 Phone: 972-551-7500 Fax: 972-524-7418
Regional Health Clinic At Terrell Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1553 State Highway 34 S, Ste 100, Terrell, TX 75160 Phone: 972-563-1475 Fax: 972-524-5132
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1553 Highway 34 S, Suite 300, Terrell, TX 75160 Phone: 972-563-1636 Fax: 972-551-6968
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 724 E Moore Ave Ste A, Terrell, TX 75160 Phone: 469-925-5832
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1553 Highway 34 S, Suite 300, Terrell, TX 75160 Phone: 972-563-4007 Fax: 972-563-4003

- Medicare Primary Care in Terrell, TX