MEDICARE: MRS. AMINATA SESAY-MBAYO NP

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	363LG0600X	Gerontology Nurse Practitioner	AP133314	TX
2	363L00000X	Nurse Practitioner	AP133314	TX

General Provider Information

NPI Number	:	1538609227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMINATA SESAY-MBAYO NP

Provider Business Mailing Address
First Line	:	11715 GRIMALDI ST
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-4515
Country	:	US
Telephone Number	:	713-517-8682
Fax Number	:

Provider Business Practice Location Address
First Line	:	11715 GRIMALDI ST
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-4515
Country	:	US
Telephone Number	:	713-517-8682
Fax Number	:

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

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	04/16/2026

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