NPI age
19 years
Enumerated 2006-12-28
● Active Type 2 · Organization
Executive De-Tails
Executive De-Tails is 1 of 801 contractor organizations in Texas.
Primary specialty
Contractor
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Aidelojie
Consultant
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 801 active contractor providers in Texas.
NPI age
19 years
↑ 8 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-12Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
2952 Celian Dr
Grand Prairie, TX 750528737
Mailing address
2952 Celian Dr
Grand Prairie, TX 750528737
Authorized official
Mark Aidelojie
Consultant
📞 8172742284
Specialties
-
Contractor PrimaryFor the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Executive De-Tails
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.