MEDICARE: RUQAYYAH A EJALONIBU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA2000X	Administrator Registered Nurse	965944	TX

General Provider Information

NPI Number	:	1255280681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUQAYYAH A EJALONIBU

Provider Business Mailing Address
First Line	:	18635 GREENWOOD MEADOW TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-4605
Country	:	US
Telephone Number	:	832-310-7771
Fax Number	:	832-308-0738

Provider Business Practice Location Address
First Line	:	18635 GREENWOOD MEADOW TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-4605
Country	:	US
Telephone Number	:	832-310-7771
Fax Number	:	832-308-0738

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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