# INVICTA FAMILY HEALTHCARE CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Regional Health Clinic at Terrell, REGIONAL HEALTH CLINIC AT TERRELL, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093235046
- **Authorized official:** DR. MICHAEL O IDEMUDIA NP (OWNER)
- **Authorized official phone:** (972) 563-1475

## Contact information

- **Practice address:** 904 W MOORE AVE STE B, TERRELL, TX 75160-3004
- **Practice address phone:** (972) 563-1475
- **Practice address fax:** (972) 524-5132
- **Mailing address:** 904 W. MOORE AVE., SUITE B, FORNEY, TX 75126-0228
- **Mailing address phone:** (972) 563-1475
- **Mailing address fax:** (972) 524-5132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | TX | Yes |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 12/19/2024