Healthcare Provider Details

I. General information

NPI: 1437453172
Provider Name (Legal Business Name): PATRICIA OBULANEY RN, ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4775 W PANTHER CREEK DR SUITE 345
THE WOODLANDS TX
77381-3592
US

IV. Provider business mailing address

4775 W PANTHER CREEK DR SUITE 345
THE WOODLANDS TX
77381-3592
US

V. Phone/Fax

Practice location:
  • Phone: 281-292-1192
  • Fax: 281-367-0396
Mailing address:
  • Phone: 281-292-1192
  • Fax: 281-367-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number552665
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: