Healthcare Provider Details

I. General information

NPI: 1871329821
Provider Name (Legal Business Name): EMPOWER CHILDREN'S CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 FLORIDA DR
ARLINGTON TX
76015-2378
US

IV. Provider business mailing address

PO BOX 3132
RIDGELAND MS
39158-3132
US

V. Phone/Fax

Practice location:
  • Phone: 469-275-8915
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: OLUWAROTIMI A. ADEPOJU
Title or Position: MD
Credential:
Phone: 813-775-5120