Healthcare Provider Details

I. General information

NPI: 1437507217
Provider Name (Legal Business Name): BIJI JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BIJIMOL LUKOSE NP

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 BERTNER AVE P115 K
HOUSTON TX
77030-2604
US

IV. Provider business mailing address

6720 BERTNER AVE P115 K
HOUSTON TX
77030-2604
US

V. Phone/Fax

Practice location:
  • Phone: 832-355-3994
  • Fax:
Mailing address:
  • Phone: 832-355-3994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP130567
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: