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NPI Code Detail

MEDICARE: MRS. TOCHUKWU TOBY UDEGBUNE AGPCNP-BC, PMHNP-BC

MEDICARE: MRS. TOCHUKWU TOBY UDEGBUNE AGPCNP-BC, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP135679TX
2363LA2200XAdult Health Nurse Practitioner312610NY
3363LA2200XAdult Health Nurse Practitioner95034194CA
4363LA2200XAdult Health Nurse PractitionerAP135679TX
5363LP0808XPsychiatric/Mental Health Nurse Practitioner407762NY

General Provider Information

NPI Number : 1467964221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TOCHUKWU TOBY UDEGBUNE AGPCNP-BC, PMHNP-BC
Provider Business Mailing Address
First Line : 9861 SAGINAW BLVD STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-5196
Country : US
Telephone Number : 817-334-1400
Fax Number :
Provider Business Practice Location Address
First Line : 5450 CLEARFORK MAIN ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-3514
Country : US
Telephone Number : 817-334-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2017
Last Update Date : 11/20/2025

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