Healthcare Provider Details

I. General information

NPI: 1629567714
Provider Name (Legal Business Name): HODA OBANDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9740 BARKER CYPRESS RD STE 108
CYPRESS TX
77433-1974
US

IV. Provider business mailing address

11103 SHELDON BEND DR
RICHMOND TX
77406-7291
US

V. Phone/Fax

Practice location:
  • Phone: 281-990-6890
  • Fax:
Mailing address:
  • Phone: 979-739-5197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP136618
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: