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KINGSWAY MEDICAL CENTER PLLC NPI 1851647911


NPI Information

NPI: 1851647911
Provider Name: KINGSWAY MEDICAL CENTER PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2061344

Address:
1030 N ZARAGOZA RD
SUITE X
EL PASO, TX
ZIP 79907
Phone: (915) 881-4155
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KINGSWAY MEDICAL CENTER PLLC is a family medicine in El Paso, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KINGSWAY MEDICAL CENTER PLLC NPI is 1851647911. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1030 N ZARAGOZA RD
SUITE X
EL PASO, TX
ZIP 79907-863
Phone: (915) 881-4155
Fax: (915) 881-4172

The provider's authorized official is Adekunle Adedeji .
The authorized official title is Owner/provider and has the following contact phone number (210) 601-2367.

The CLIA number assigned to this NPI record is 45D2061344 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2012 and was last updated on 5/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133V00000XDietitian, RegisteredNo
2207Q00000XFamily MedicineN3416TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13058117-01MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.