Healthcare Provider Details

I. General information

NPI: 1144671017
Provider Name (Legal Business Name): IJEOMA BETHEL DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23920 KATY FWY STE 540
KATY TX
77494-0882
US

IV. Provider business mailing address

1833 RICHMOND PARKWAY SUITE 1500
RICHMOND TX
77469
US

V. Phone/Fax

Practice location:
  • Phone: 281-644-8750
  • Fax:
Mailing address:
  • Phone: 775-232-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP130872
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: