Provider Demographics
NPI:1063926749
Name:NDUBISI, NWANNEOMA PATRICIA (FNP)
Entity type:Individual
Prefix:
First Name:NWANNEOMA
Middle Name:PATRICIA
Last Name:NDUBISI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 SOUTHWEST FWY STE 100A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1523
Mailing Address - Country:US
Mailing Address - Phone:281-310-7169
Mailing Address - Fax:866-407-9992
Practice Address - Street 1:9100 SOUTHWEST FWY STE 100A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1523
Practice Address - Country:US
Practice Address - Phone:281-310-7169
Practice Address - Fax:866-407-9992
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty