Individual
EUNICE E GBENOBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-2727
Mailing address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-2727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
558854
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP113893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197482601
—
TX
05
—
197482602
—
TX
05
—
197482603
—
TX
01
—
8Y0370
BLUE CROSS BLUE SHIELD
—
01
—
P01023365
MEDICARE RR
TX
Enumeration date
07/10/2006
Last updated
01/18/2022
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