MEDICARE: GABRIEL NKWANYUO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	915145	TX

General Provider Information

NPI Number	:	1013866029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL NKWANYUO

Provider Business Mailing Address
First Line	:	2507 MUSTANG CT
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-2415
Country	:	US
Telephone Number	:	682-200-4272
Fax Number	:	682-719-4099

Provider Business Practice Location Address
First Line	:	941 YORK DR STE 201
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2066
Country	:	US
Telephone Number	:	682-200-4272
Fax Number	:	682-719-4099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “ GABRIEL NKWANYUO ” Practice Location

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