MEDICARE: GRACEVILLE 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
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1427902600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEVILLE PEDIATRICS, PLLC

Provider Business Mailing Address
First Line	:	8751 COLLIN MCKINNEY PKWY STE 1102
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-1872
Country	:	US
Telephone Number	:	469-884-7233
Fax Number	:	469-429-5369

Provider Business Practice Location Address
First Line	:	8751 COLLIN MCKINNEY PKWY STE 1102
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-1872
Country	:	US
Telephone Number	:	469-884-7233
Fax Number	:	469-429-5369

Authorized Official
Title or Position	:	CEO
Name	:	DR. OLUBUKOLA TEKEBA ADEYEYE
Credential	:	MD
Telephone Number	:	469-884-7233

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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