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NPI Code Detail

MEDICARE: MERCY C OLUMUYIWA

MEDICARE:   MERCY C OLUMUYIWA
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
1363LF0000XFamily Nurse PractitionerAP129846TX
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP129846TX

General Provider Information

NPI Number : 1598129504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERCY C OLUMUYIWA
Provider Business Mailing Address
First Line : 6014 TURNER SHADOW LN
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3629
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 511 W TIDWELL RD
Second Line :
City : HOUSTON
State : TX
Zip : 77091-4338
Country : US
Telephone Number : 512-207-0059
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2016
Last Update Date : 11/29/2023

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Directions to “ MERCY C OLUMUYIWA ” Practice Location

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