Individual provider Active NPI

Gabriella Oseme Udabor, FNP

  • Family Nurse Practitioner
  • Lewisville, TX
National Provider Identifier
1063769891
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
750379 Issued in TX
Practice address
2035 Camelot Dr
Lewisville, TX 75067-2027
Phone
(972) 938-6915
NPI assigned
Aug 10, 2012
Last updated
Sep 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 750379 TX Primary

Addresses

Primary practice location

2035 Camelot Dr
Lewisville, TX 75067-2027

Mailing address

2035 Camelot Dr
Lewisville, TX 75067-2027
Phone (972) 938-6915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000710 TX Practitioner - Nurse Practitioner 0244472066 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Holistic Health PLLC CurrentSince Nov 27, 2023 Accepting new patients

Locations

1244 William D Tate Ave
Grapevine, TX 76051
Phone (817) 416-9800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1063769891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 CAMELOT DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750672027",
            "telephone_number": "972-938-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 CAMELOT DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750672027",
            "telephone_number": "972-938-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDABOR",
        "first_name": "GABRIELLA",
        "middle_name": "OSEME",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "750379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.