Active NPI
Vivian Igboalisi
- Psychiatric/Mental Health Nurse Practitioner
- Katy, TX
National Provider Identifier
1023724994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1070398
- Practice address
- 26726 Sooty Tern Dr
Katy, TX 77494-6883 - Phone
- (832) 457-0293
- NPI assigned
- Jan 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1070398 | TX | Primary |
Addresses
Primary practice location
26726 Sooty Tern Dr
Katy, TX 77494-6883
Mailing address
26726 Sooty Tern Dr
Katy, TX 77494-6883
Phone (832) 457-0293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1023724994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26726 SOOTY TERN DR",
"city": "KATY",
"state": "TX",
"postal_code": "774946883",
"telephone_number": "832-457-0293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26726 SOOTY TERN DR",
"city": "KATY",
"state": "TX",
"postal_code": "774946883",
"telephone_number": "832-457-0293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGBOALISI",
"first_name": "VIVIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-25",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1070398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.