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NPI Code Detail

MEDICARE: TEXOMA PEDIATRICS, PLLC

MEDICARE: TEXOMA PEDIATRICS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4154OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2I36843OTHEROKNPI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518307529
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXOMA PEDIATRICS, PLLC
Provider Business Mailing Address
First Line : PO BOX 128
Second Line :
City : DURANT
State : OK
Zip : 74702-0128
Country : US
Telephone Number : 580-920-1980
Fax Number : 580-920-9937
Provider Business Practice Location Address
First Line : 430 BRYAN DR
Second Line :
City : DURANT
State : OK
Zip : 74701-3467
Country : US
Telephone Number : 580-920-1980
Fax Number : 580-920-9937
Authorized Official
Title or Position : OWNER
Name : MICHAEL SIMULESCU
Credential : D.O.
Telephone Number : 580-920-1980
Provider Enumeration Date : 07/05/2013
Last Update Date : 06/08/2026

Similar Medicare Providers

1417154352 — MICHAEL JOHN STEVE SIMULESCU D.O.
Practice Location Address:
430 BRYAN DR
DURANT, OK
74701-3467
Practice Phone: 580-920-1980
Practice Fax: 580-920-9937
1659372738 — DR. JAMIE AKIN D.O.
Practice Location Address:
430 BRYAN DR
DURANT, OK
74701-3467
Practice Phone: 580-920-1980
Practice Fax: 580-920-9937
1558990028 — DANIEL YOUNG KIM DO
Practice Location Address:
430 BRYAN DR
DURANT, OK
74701-3467
Practice Phone: 580-920-1980
Practice Fax: 580-920-9937
1447184395 — BRADY TURNER
Practice Location Address:
1600 N WASHINGTON AVE
DURANT, OK
74701-2128
Practice Phone: 590-706-6936
Practice Fax:
1225965981 — IRONGATE BEHAVIORAL HEALTH LLC
Practice Location Address:
698 WESTSIDE DR
DURANT, OK
74701-3084
Practice Phone: 206-492-0723
Practice Fax:
1780518712 — MADILYN TUBBS
Practice Location Address:
1600 W UNIVERSITY BLVD
DURANT, OK
74701-3045
Practice Phone: 580-740-0205
Practice Fax: 580-634-2848

Directions to “TEXOMA PEDIATRICS, PLLC ” Practice Location

Language Start Address Practice Location
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