| Wellcare Family Clinic, Inc. | |
|
18110 Midway Rd Ste 136 Dallas TX 75287-6632 | |
| (214) 613-6009 | |
| (214) 613-6002 |
| Full Name | Wellcare Family Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 18110 Midway Rd Ste 136, Dallas, Texas |
| Authorized Official Name and Position | Godling Obi Onyegbunwa (ADMINISTRATOR) |
| Authorized Official Contact | 9727045550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellcare Family Clinic, Inc. 18110 Midway Rd Ste 136 Dallas TX 75287-6632 Ph: (972) 704-5550 | Wellcare Family Clinic, Inc. 18110 Midway Rd Ste 136 Dallas TX 75287-6632 Ph: (214) 613-6009 |
| NPI Number | 1114481561 |
|---|---|
| Provider Enumeration Date | 01/29/2019 |
| Last Update Date | 04/11/2022 |
| Medicare PECOS PAC ID | 8123425188 |
|---|---|
| Medicare Enrollment ID | O20210920000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114481561 | NPI | - | NPPES |
| Provider Name | Lillian Onyegbunwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801248745 PECOS PAC ID: 4981775871 Enrollment ID: I20170530002218 |
| Provider Name | Godling Obi Onyegbunwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588299077 PECOS PAC ID: 3072684968 Enrollment ID: I20201118002300 |
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