OPTIMED HEALTHCARE CLINIC LLC (NPI# 1295197630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295197630 |
| Entity Type | Organization |
| Organization Name | OPTIMED HEALTHCARE CLINIC LLC |
| Practice Address |
6321 San Marino Dr Rowlett TX 75089-4534 |
| Practice Telephone | 2142052792 |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |
| Authorized Official Name | ANITA CHACKO (OWNER) |
| Authorized Official Telephone | 2142052792 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6321 SAN MARINO DR |
| City | ROWLETT |
| State | TX |
| Zip Code | 75089-4534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962022434 | Rowlett Tiny Teeth, Pllc | Dentist | 5404 Kenwood Drive, Rowlett, TX 75089 | 2020-04-24 |
| 1194292219 | Jacqueline G. Abraham | Physician Assistant | 9517 Fairway Vista Dr, Rowlett, TX 75089 | 2018-10-26 |
| 1487121810 | Eglorious, Inc. | Registered Nurse | 7314 Westhaven Dr., Rowlett, TX 75089 | 2018-10-24 |
| 1164901252 | Amber Saenz | Physical Therapist | 6706 Bluebell Dr, Rowlett, TX 75089 | 2018-08-09 |
| 1538544937 | Dallas Specialty Pharmacy,llc | Pharmacy | 5501 Gordon Smith, Suite 170, Rowlett, TX 75089 | 2015-07-27 |
| 1568782274 | Alix H. Sanders Jr. | Dentist | 7100 Rowlett Rd., Rowlett, TX 75089 | 2010-06-03 |
| 1174661318 | Anita Gaye Henrichson | Counselor | 9709 Peachtree Lane, Rowlett, TX 75089 | 2007-02-01 |
| 1689685133 | Mark Wayne Boren | Dentist | 7100 Rowlett Rd, Rowlett, TX 75089 | 2006-08-10 |
| 1750696803 | Care With Honor LLC | Community/Behavioral Health | 6114 San Marino Ct, Rowlett, TX 75089-0756 | 2010-08-13 |
| 1740423193 | A Time To Heal Health Care Services LLC | Home Health | 2713 Planetree Dr, Rowlett, TX 75089-1615 | 2009-04-15 |
| Find all providers in zip 75089 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861938904 | Franklin Fru | Nurse Practitioner | 10018 Turrey Pnes, Rowlett, TX 75089-8447 | 2017-01-12 |
| 1518367291 | Merina Johnson | Nurse Practitioner | 10018 Broadmoor Ln, Rowlett, TX 75089-8379 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215800 | Kellie Lynn Myers | Nurse Practitioner | 26015 Penguin St, Magnolia, TX 77355-6249 | 2020-11-06 |
| 1356942148 | Nina Nicole Totanes | Nurse Practitioner | 12709 Toepperwein Rd Ste 203, Live Oak, TX 78233-3259 | 2020-11-06 |
| 1841890415 | Glenda Kelley | Nurse Practitioner | 8902 W State Highway 56, Savoy, TX 75479-3460 | 2020-10-31 |
| 1184223786 | Vincy Saji Mathew | Nurse Practitioner | 8804 Viridian Ln, Fort Worth, TX 76123-4030 | 2020-10-23 |
| 1265030787 | Lissa Flory | Nurse Practitioner | 4679 Dreibrodt Rd, San Marcos, TX 78666-3388 | 2020-10-16 |
| 1235737941 | Barton Skinner | Nurse Practitioner | 17806 W I-10, Suite 300, San Antonio, TX 78257 | 2020-10-14 |
| 1972101897 | Biny Sam George | Nurse Practitioner | 7207 Baitland Dr, Missouri City, TX 77459-2035 | 2020-10-13 |
| 1285231282 | Nkechi I Carter | Nurse Practitioner | 1550 Katy Gap Rd Apt 1406, Katy, TX 77494-5878 | 2020-10-03 |
| 1770190753 | Julius Osabor Obianke | Nurse Practitioner | 1000 Fallon Dr, Mckinney, TX 75071-1210 | 2020-09-24 |
| 1740896315 | Mackenzie Brooks Jackson | Nurse Practitioner | 46 N Creekside Ct, Houston, TX 77055-7540 | 2020-09-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.