Healthcare Provider Details

I. General information

NPI: 1730969940
Provider Name (Legal Business Name): PASCAL EGBE EGBE DNP-FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 UNIVERSITY DR E STE 345
BRYAN TX
77802-3484
US

IV. Provider business mailing address

1800 HOLLEMAN DR APT 217
COLLEGE STATION TX
77840-7208
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-2715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1032424
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: