Organization
MESQUITE MEDICAL GROUP, LLC
Active
Organization
MESQUITE MEDICAL GROUP, LLC
Active
Other names
PA Housecalls
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEWUMI ADEWALE BAKARE DMS, PA (CEO)
(214) 660-8554
Entity
Organization
Contact information
Practice address
5115 N GALLOWAY AVE STE 203, MESQUITE, TX 75150-7535
(214) 660-8554
(214) 660-8634
Mailing address
5115 N GALLOWAY AVE STE 203, MESQUITE, TX 75150-7535
(214) 660-8554
(214) 660-8634
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N0064
TX
261Q00000X
Clinic/Center
N0064
TX
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
PA06308
TX
363A00000X
Physician Assistant
PA06380
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283257801
—
TX
01
—
TXB125532
MEDICARE PART B
TX
Enumeration date
11/01/2010
Last updated
05/09/2022
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