Ebima Okundaye P.a.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EBIMA OKUNDAYE P.A.

Practice address

3315 Burke Rd Ste 306
Pasadena, TX 77504-1825

Phone

(832) 831-6135

Fax

(832) 925-8917

NPI assigned

Dec 3, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ebima Okundaye, MDNPI 1063546406

Title

Owner

Phone

(973) 885-5457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ebima Clifford Okundaye, M.D

  • Nephrology Physician
  • Pearland, TX
  • NPI 1063546406
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1003453671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1571",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775451571",
            "telephone_number": "832-831-6135",
            "fax_number": "832-925-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 BURKE RD STE 306",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041825",
            "telephone_number": "832-831-6135",
            "fax_number": "832-925-8917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10970 Shadow Creek Pkwy Ste 220",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775840102",
            "country_code": "US",
            "telephone_number": "832-831-6135",
            "fax_number": "832-925-8917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EBIMA OKUNDAYE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2024-02-07",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "OKUNDAYE",
        "authorized_official_first_name": "EBIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-885-5457",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.