Provider Demographics
NPI:1154973378
Name:FUSION CARE PLLC
Entity type:Organization
Organization Name:FUSION CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE NURSE
Authorized Official - Prefix:
Authorized Official - First Name:OLAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-839-5277
Mailing Address - Street 1:23410 GRAND RESERVE DR STE 705
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4983
Mailing Address - Country:US
Mailing Address - Phone:713-839-5277
Mailing Address - Fax:
Practice Address - Street 1:23410 GRAND RESERVE DR STE 705
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4983
Practice Address - Country:US
Practice Address - Phone:713-839-5277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty