Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael G Omotola, PA-C

Individual provider Physician Assistant · NPI 1124505615

Michael G Omotola, PA-C is a Physician Assistant in Grand Prairie, Texas. Graduated from Eastern Virginia Medical School in 2018, 8 years ago. Practices with Primamed Physicians, PLLC, a 63-clinician group and accepts Medicare assignment.

Years since qualifying
8
Trained at
Eastern Virginia Medical School
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2520 W I 20
Grand Prairie, TX 75052-7280
Phone: (512) 363-3257
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1124505615
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 26, 2018
Last updated in NPPESJuly 26, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2018 (8 years in practice)
Group practice Primamed Physicians, Pllc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations21 on file with Medicare

Other providers in Grand Prairie