Individual
IYABO MERCY OMIDIWURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
4800 SUGAR GROVE BLVD STE 250, STAFFORD, TX 77477-2639
(832) 554-6773
Mailing address
4800 SUGAR GROVE BLVD STE 250, STAFFORD, TX 77477-2639
(832) 554-6773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
952285
TX
363L00000X
Nurse Practitioner
Primary
1100163
TX
363L00000X
Nurse Practitioner
AC008119
MD
363L00000X
Nurse Practitioner
AC008119
TX
Other
Enumeration date
09/14/2018
Last updated
05/03/2026
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