Provider Demographics
NPI:1225751274
Name:EGUASA, VALERIE OSAYEMWENRE (NP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:OSAYEMWENRE
Last Name:EGUASA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6210 E HWY 290 STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15803 WINDERMERE DR STE 103
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2482
Practice Address - Country:US
Practice Address - Phone:512-989-2680
Practice Address - Fax:512-406-7339
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1089370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner