Organization
KINKAID MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEMI ADESOLA (DIRECTOR)
(346) 874-7874
Entity
Organization
Contact information
Practice address
3727 GREENBRIAR DR STE 118, STAFFORD, TX 77477-3929
(346) 874-7874
Mailing address
PO BOX 642, STAFFORD, TX 77497-0642
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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