CLARA FORMUSOH (NPI# 1023406576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023406576 |
| Entity Type | Individual |
| Full Name | CLARA FORMUSOH |
| Credential | NP |
| Practice Address |
1300 W Terrell Ave Ste K230 Fort Worth TX 76104-2820 |
| Practice Telephone | 8172504906 |
| Practice Fax Number | 8172501815 |
| Mailing Telephone | 8172504906 |
| Mailing Fax Number | 8172501815 |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2016-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP127181 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 343075301 | 05 |
| Street Address |
1300 W TERRELL AVE STE K230 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-2820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528040193 | Gargeyi Bandaru | Internal Medicine | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2005-11-18 |
| 1154897502 | Emmanuel Etuokwu | Registered Nurse | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2018-10-23 |
| 1194225920 | Jorge E Rico IIi | Nurse Practitioner | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2018-02-19 |
| 1912430323 | Faraaz Yousufi | Internal Medicine | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2017-04-04 |
| 1215471735 | Andrea Torrey | Nurse Practitioner | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2016-12-19 |
| 1538534920 | Jasmin Young | Nurse Practitioner | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2015-12-10 |
| 1801272570 | Blessing Chimenga | Nurse Practitioner | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2015-08-05 |
| 1316280274 | John Hoang | Internal Medicine | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2013-03-28 |
| 1851647044 | Scott A Edegbe | Nurse Practitioner | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2012-07-25 |
| 1083979405 | Ofonime Anthony Isokrari | Registered Nurse | 1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-2820 | 2012-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556341 | Sarah R Tabor | Nurse Practitioner | 4819 El Campo Ave, Fort Worth, TX 76107-4917 | 2020-10-21 |
| 1336747963 | Thomas Liles | Nurse Practitioner | 4 Carlson Ct, Fort Worth, TX 76119-5901 | 2020-10-15 |
| 1518565597 | Khyatiben Harsh Parikh | Nurse Practitioner | 8121 Belgian Blue Ct, Fort Worth, TX 76131-1734 | 2020-10-13 |
| 1225645906 | Manju Karki K C | Nurse Practitioner | 4812 Meadow Falls Dr # A, Fort Worth, TX 76244-2308 | 2020-09-28 |
| 1497361778 | Mulikat Dossou | Nurse Practitioner | 8024 Valley Crest Dr, Fort Worth, TX 76120-5651 | 2020-09-22 |
| 1275148793 | Bianca Adrianna Agnello | Nurse Practitioner | 8465 Boat Club Rd Ste 115, Fort Worth, TX 76179-3676 | 2020-09-11 |
| 1356955363 | Alba C. Rivas | Nurse Practitioner | 6958 Legato Ln, Fort Worth, TX 76134-3727 | 2020-09-07 |
| 1043824139 | Traci D Huff | Nurse Practitioner | 7121 Sundance Ln, Fort Worth, TX 76179-2533 | 2020-09-04 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1619589108 | Megan King | Nurse Practitioner | 9734 N Beach St Ste 100, Fort Worth, TX 76244-6185 | 2020-08-18 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on CLARA FORMUSOH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.