Healthcare Provider Details

I. General information

NPI: 1811821093
Provider Name (Legal Business Name): DR. MORI LOBE
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: DR. MORI LOBE TEPONDJOU

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW GAGE BLVD
TOPEKA KS
66622-0001
US

IV. Provider business mailing address

300 STATE ST UNIT 92434
SOUTHLAKE TX
76092-1215
US

V. Phone/Fax

Practice location:
  • Phone: 785-350-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1002073
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: