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General NPI Number Information
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NPI Number | 1194335240
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Entity Type | Individual
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Provider Name | MRS. EBIKA EYONG MBUAGBAW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1420 FM 1960 BYPASS RD E STE 116
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City | HUMBLE
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State | TX
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Zip | 77338-3934
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Country | US
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Telephone | 713-457-4372
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Fax |
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Provider Business Mailing Address
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Address Line | 13623 ELDRIDGE SPRINGS WAY
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City | HOUSTON
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State | TX
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Zip | 77083-6538
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Country | US
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Telephone | 165-167-5731
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP145966
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License Number State | TX
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