MEDICARE: JIBRIL YAKUBU NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP141216	TX

General Provider Information

NPI Number	:	1821631201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIBRIL YAKUBU NP

Provider Business Mailing Address
First Line	:	6902 S PEEK RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6902 S PEEK RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1741
Country	:	US
Telephone Number	:	832-535-2770
Fax Number	:

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

Provider Enumeration Date	:	10/18/2019
Last Update Date	:	10/21/2019

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