MEDICARE: EMPOWER CHILDREN'S CLINIC PA

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	:	1871329821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER CHILDREN'S CLINIC PA

Provider Business Mailing Address
First Line	:	PO BOX 3132
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39158-3132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 FLORIDA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2378
Country	:	US
Telephone Number	:	469-275-8915
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	OLUWAROTIMI A. ADEPOJU
Credential	:
Telephone Number	:	813-775-5120

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	12/15/2025

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