MEDICARE: FIDELIS UBONG IBE

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	363L00000X	Nurse Practitioner	1129412	TX

General Provider Information

NPI Number	:	1780548529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FIDELIS UBONG IBE

Provider Business Mailing Address
First Line	:	14906 WESTPARK DR APT 2032
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4967
Country	:	US
Telephone Number	:	281-236-9242
Fax Number	:

Provider Business Practice Location Address
First Line	:	14906 WESTPARK DR APT 2032
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4967
Country	:	US
Telephone Number	:	281-236-9242
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ FIDELIS UBONG IBE ” Practice Location

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