Provider Demographics
NPI:1306250519
Name:NYAGA, GLADYS (FNP, RN)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:NYAGA
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27120 FULSHEAR BEND DR STE 900-53
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1190
Mailing Address - Country:US
Mailing Address - Phone:832-885-0832
Mailing Address - Fax:
Practice Address - Street 1:2626 S LOOP W STE 265
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5636
Practice Address - Country:US
Practice Address - Phone:713-796-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX792982163WC1600X, 163WI0600X, 171M00000X
TX1074590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No171M00000XOther Service ProvidersCase Manager/Care Coordinator