Provider Demographics
NPI:1508338344
Name:ACCESS MEDICAL GROUP
Entity Type:Organization
Organization Name:ACCESS MEDICAL GROUP
Other - Org Name:AMG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OKWUCHI
Authorized Official - Middle Name:V
Authorized Official - Last Name:ADODO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-844-3203
Mailing Address - Street 1:26502 CRIMSON BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7655
Mailing Address - Country:US
Mailing Address - Phone:718-844-3203
Mailing Address - Fax:
Practice Address - Street 1:26502 CRIMSON BLUFF LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7655
Practice Address - Country:US
Practice Address - Phone:718-844-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care