PETER FORMUSOH (NPI# 1114559325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114559325 |
| Entity Type | Individual |
| Full Name | PETER FORMUSOH |
| Practice Address |
4635 Southwest Fwy Ste 635 Houston TX 77027-7112 |
| Practice Telephone | 7138500049 |
| Practice Fax Number | 7136277302 |
| Mailing Telephone | 7138500049 |
| Mailing Fax Number | 7136277302 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP140067 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP140067 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4635 SOUTHWEST FWY STE 635 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77027-7112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538172812 | Paul David Wadler | Psychologist | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2006-08-15 |
| 1104458108 | Stephanie Stockton | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2020-02-07 |
| 1548891047 | Jennifer Lee | Social Worker | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2020-02-03 |
| 1801427141 | Perpetua Eze | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2020-01-27 |
| 1699312926 | Vivian Young | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2019-12-05 |
| 1578119582 | Valarie Johnson | Social Worker | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2019-08-15 |
| 1952860124 | Alisha Neal | Social Worker | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2019-03-18 |
| 1154885630 | Wendy Lewis | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2019-01-29 |
| 1881164788 | Karen Bowery | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2018-12-04 |
| 1275009292 | Kyle Deirdre Johnson | Nurse Practitioner | 4635 Southwest Fwy Ste 635, Houston, TX 77027-7112 | 2018-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104456185 | River Oaks Senior Living LLC | Assisted Living Facility | 4 Briar Dale Ct, Houston, TX 77027 | 2020-01-18 |
| 1477191757 | Holistic Innovative Interventional Pain Associates Pllc | General Practice | 4615 Southwest Freeway #850, Houston, TX 77027 | 2019-12-17 |
| 1841837986 | Veronica Welch | Social Worker | 464 Wild Indigo, Suite 150, Houston, TX 77027 | 2019-12-09 |
| 1184288805 | Gabriella Postalian-rizzo | Dentist | 4126 Southwest Freeway, Suite 1040, Houston, TX 77027 | 2019-04-29 |
| 1659856680 | Rachel Menges | Nurse Practitioner | 4200 Twelve Oaks Place, Houston, TX 77027 | 2018-09-25 |
| 1295217503 | New Way Psychological Services, Pllc | Psychologist | 2100 West Loop South Suite 800, Houston, TX 77027 | 2018-09-04 |
| 1760960892 | Emily Moore Netherton | Social Worker | 4646 Wild Indigo, Suite 150, Houston, TX 77027 | 2018-07-31 |
| 1548757826 | Foundations Pediatric Therapy of Houston | Occupational Therapist | 3312 Marquart Street, Houston, TX 77027 | 2018-04-22 |
| 1962905091 | Christina Raeann Gkinos | Licensed Practical Nurse | 3315 Marquart Street, 209, Houston, TX 77027 | 2018-03-15 |
| 1508366337 | Florence Okotie | Registered Nurse | 3315 Marquette St, Houston, TX 77027 | 2018-02-19 |
| Find all providers in zip 77027 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255162 | Shaida Rahmatinick | Nurse Practitioner | 1515 W 22nd St, Houston, TX 77008-1501 | 2020-11-08 |
| 1104426311 | Erin Krim Gordon | Nurse Practitioner | 2202 Quenby St, Houston, TX 77005-1502 | 2020-10-27 |
| 1003415902 | Hope Ozumba | Nurse Practitioner | 8544 Dairy View Ln, Houston, TX 77072-3907 | 2020-10-21 |
| 1487253761 | Khanh Vu Phuong Nguyen | Nurse Practitioner | 13218 Bellaire Bld, Houston, TX 77083 | 2020-10-19 |
| 1962001362 | Eshcol Clinic | Nurse Practitioner | 9935 Bissonnet St Unit B, Houston, TX 77036-8413 | 2020-10-19 |
| 1013516483 | Shazia Mominkhawaja | Nurse Practitioner | 2222 Greenhouse Rd Ste 400, Houston, TX 77084-7288 | 2020-10-18 |
| 1851908610 | Iyobo Elegon | Nurse Practitioner | 8511 Dawnridge Dr, Houston, TX 77071-2441 | 2020-09-25 |
| 1548877541 | Lifespan Psychiatry and Wellness Center Pllc | Nurse Practitioner | 8700 Commerce Park Dr Ste 220, Houston, TX 77036-7431 | 2020-09-24 |
| 1811503345 | Alyssa Cory Hildebrand | Nurse Practitioner | 2450 Fondren Rd Ste 111, Houston, TX 77063-2314 | 2020-09-21 |
| 1245846088 | Adriana Ortiz | Nurse Practitioner | 7218 Shady Corners Ln, Houston, TX 77040-4733 | 2020-09-17 |
| Find all providers in HOUSTON | ||||
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| 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.