Healthcare Provider Details

I. General information

NPI: 1073186110
Provider Name (Legal Business Name): AUGUSTINA CYNTHIA NJOKU-GUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 HALSTEAD ST
MISSOURI CITY TX
77489-3108
US

IV. Provider business mailing address

1826 HALSTEAD ST
MISSOURI CITY TX
77489-3108
US

V. Phone/Fax

Practice location:
  • Phone: 713-482-9595
  • Fax:
Mailing address:
  • Phone: 713-482-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1025841
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: