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PEDICARE CHILDRENS CLINIC PA
NPI 1255862074
Pediatrics in Midland, TX

Active since March 23, 2017CLIA Certified · 3 labs
2101 N MIDLAND DR STE 14A, MIDLAND, TX 79707(432) 695-6300(326) 956-5714 Get Directions Write a Review

NPPES record last updated: February 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 10, 2022, Feb 11, 2021, Oct 26, 2018 and 1 more (4 updates tracked since 2017).

About Pedicare Childrens Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDICARE CHILDRENS CLINIC PA (NPI 1255862074) is a healthcare organization registered as a pediatrics in Midland, Texas and active in the NPI registry since March 2017. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Kingsley Okonkwo, President, as its authorized official.

NPPES Registry Identity

NPI1255862074
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDICARE CHILDRENS CLINIC PA
Location Address2101 N MIDLAND DR STE 14AMidland, TX 79707-5507
Mailing Address2101 N Midland Dr Ste 14aMidland, TX 79707-5507 · (432) 695-6300 · Fax (432) 695-6571
Phone(432) 695-6300
Fax(326) 956-5714
Organization SubpartNo
Authorized OfficialKingsley OkonkwoPresident · (361) 334-0613
Enumeration DateMarch 23, 2017
Last NPPES UpdateFebruary 10, 20224 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2022
✔ NPI 1255862074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in TX · P4362✔ Licensed in TX · Q5518
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
2101 N MIDLAND DR STE 14A, Midland, TX 79707
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Secondary Practice Locations 2

Location 16326 Yorktown Blvd Ste 1ACorpus Christi, TX 78414-5861 · Phone (361) 334-0613
Location 2912 E 5th StOdessa, TX 79761-4605 · Phone (432) 334-8845

Other Identifiers 3

OtherQ5518TX · State License
OtherAP144543TX · All
OtherP4362TX · State License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2177712

Pedicare Children's Clinic PA · Corpus Christi, TX
Active · expires Jan 15, 2028
CLIA Number45D2177712
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2026
Certificate Expiration DateJanuary 15, 2028
Laboratory DirectorOdumusi Kolawole
Laboratory Phone(361) 334-0613
Laboratory LocationPedicare Children's Clinic PA6326 Yorktown, Corpus Christi, TX 78414
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2163442

Pedicare Children's Clinic PA · Odessa, TX
Active · expires Mar 13, 2027
CLIA Number45D2163442
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2025
Certificate Expiration DateMarch 13, 2027
Laboratory DirectorKolawole Odumusi
Laboratory Phone(432) 334-8845
Laboratory LocationPedicare Children's Clinic PA912 E 5th St, Odessa, TX 79761
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2158102

Pedicare Children's Clinic PA · Midland, TX
Active · expires Nov 19, 2026
CLIA Number45D2158102
Laboratory TypePhysician Office
Certificate Effective DateNovember 20, 2024
Certificate Expiration DateNovember 19, 2026
Laboratory DirectorKolawole Odumusi
Laboratory Phone(432) 695-6300
Laboratory LocationPedicare Children's Clinic PA2101 North Midland Drive Suite 14A, Midland, TX 79707
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLUWATIMILEHIN DARAMOLA
Physician Assistant
2101 N MIDLAND DR STE 14A
MIDLAND, TX 79707
Midland County (432) 695-6300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pedicare Childrens Clinic PA's NPI number?

The NPI number for Pedicare Childrens Clinic PA is 1255862074. It was assigned to this organization in the NPPES registry on March 23, 2017.

Where is Pedicare Childrens Clinic PA located?

Pedicare Childrens Clinic PA is located at 2101 N Midland Dr Ste 14A, Midland, TX 79707. The listed phone number is (432) 695-6300.

What is Pedicare Childrens Clinic PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Pedicare Childrens Clinic PA hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pedicare Childrens Clinic PA was last updated on February 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.