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MICHAEL E ESEDEBE MDPA NPI 1740343177


NPI Information

NPI: 1740343177
Provider Name: MICHAEL E ESEDEBE MDPA

Doing Business As: AUDELIA MEDICAL CENTER

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
11617 N CENTRAL EXPY
SUITE 240
DALLAS, TX
ZIP 75243
Phone: (214) 553-1516
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MICHAEL E ESEDEBE MDPA is a clinic center in Dallas, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MICHAEL E ESEDEBE MDPA NPI is 1740343177. The provider is registered as an organization entity type.
The provider Is Doing Business As Audelia Medical Center.

The provider's business location address is:

11617 N CENTRAL EXPY
SUITE 240
DALLAS, TX
ZIP 75243-800
Phone: (214) 553-1516
Fax: (214) 553-1519

The provider's authorized official is Michael Emeka Esedebe .
The authorized official title is Medical Director and has the following contact phone number (214) 336-9559.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 2/1/2012.


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
1261Q00000XClinic/CenterL0155TEXASYes

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
1H10182MEDICARE UPINTEXAS
2047474404MEDICAIDTEXAS

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: 11/14/2023

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