Individual provider Active NPI

Rebecca Adadzewa Omenukor

  • Psychiatric/Mental Health Registered Nurse
  • Katy, TX
National Provider Identifier
1104768936
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
1100550 Issued in TX
Practice address
633 E Fernhurst Dr Ste 304
Katy, TX 77450-1586
Phone
(877) 631-0010
NPI assigned
Apr 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1100550 TX Primary

Addresses

Primary practice location

633 E Fernhurst Dr Ste 304
Katy, TX 77450-1586

Mailing address

633 E Fernhurst Dr Ste 304
Katy, TX 77450-1586
Phone (877) 631-0010

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
1100550TXMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1104768936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 E FERNHURST DR STE 304",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501586",
            "telephone_number": "877-631-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E FERNHURST DR STE 304",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501586",
            "telephone_number": "877-631-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMENUKOR",
        "first_name": "REBECCA",
        "middle_name": "ADADZEWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1100550",
            "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 Apr 9, 2026; 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.