Healthcare Provider Details

I. General information

NPI: 1619479623
Provider Name (Legal Business Name): BETTY OBUYA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date: 06/22/2020
Reactivation Date: 03/03/2025

III. Provider practice location address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 713-280-9800
  • Fax:
Mailing address:
  • Phone: 713-280-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1000230
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: