Healthcare Provider Details

I. General information

NPI: 1528480217
Provider Name (Legal Business Name): JOY ISIOMA ODAFE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7821 FM 1960 RD E
HUMBLE TX
77346-2205
US

IV. Provider business mailing address

7821 FM 1960 RD E
HUMBLE TX
77346-2205
US

V. Phone/Fax

Practice location:
  • Phone: 832-966-3376
  • Fax:
Mailing address:
  • Phone: 832-966-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number732803
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: