Individual provider Active NPI

Nneamaka Victoria Imo

  • Registered Nurse
  • Houston, TX
National Provider Identifier
1033690391
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
853908 Issued in TX
Practice address
11924 Braes Park Dr
Houston, TX 77071-7707
Phone
(832) 989-2759
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 853908 TX Primary

Addresses

Primary practice location

11924 Braes Park Dr
Houston, TX 77071-7707

Mailing address

11924 Braes Park Dr
Houston, TX 77071-3279
Phone (832) 221-2402

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
853908TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1033690391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11924 BRAES PARK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770713279",
            "telephone_number": "832-221-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11924 BRAES PARK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770717707",
            "telephone_number": "832-989-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMO",
        "first_name": "NNEAMAKA",
        "middle_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "853908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.