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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