MEDICARE: JOY ONYEUGWOR FNP-C

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	207Q00000X	Family Medicine Physician	1110432	TX
2	363LF0000X	Family Nurse Practitioner	1110432	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1110432	OTHER	TX	APRN LICENSE

General Provider Information

NPI Number	:	1457058554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY ONYEUGWOR FNP-C

Provider Business Mailing Address
First Line	:	649 HUTCHINS DR
Second Line	:
City	:	CROWLEY
State	:	TX
Zip	:	76036-2749
Country	:	US
Telephone Number	:	817-703-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	6029 BELT LINE RD STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-7873
Country	:	US
Telephone Number	:	855-893-5637
Fax Number	:	817-666-3873

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

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	05/01/2024

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Directions to “ JOY ONYEUGWOR FNP-C” Practice Location

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