MEDICARE: MERCY ABIDOYE - FAKOYA FNP

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	363LF0000X	Family Nurse Practitioner	AP127163	TX

General Provider Information

NPI Number	:	1053702944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCY ABIDOYE - FAKOYA FNP

Provider Business Mailing Address
First Line	:	11665 S HIGHWAY 6
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77498-1302
Country	:	US
Telephone Number	:	832-999-4306
Fax Number	:

Provider Business Practice Location Address
First Line	:	11665 S HIGHWAY 6
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-1302
Country	:	US
Telephone Number	:	832-999-4306
Fax Number	:

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

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	07/21/2022

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