Individual provider Active NPI

Stephen M Mbola, ANP

  • Adult Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1134433113
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP117709 Issued in TX
Practice address
2626 S Loop W Ste 265
Houston, TX 77054-5636
Phone
(713) 796-9955
NPI assigned
Aug 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 666178 TX
Adult Health Nurse Practitioner 363LA2200X AP117709 TX Primary

Addresses

Primary practice location

2626 S Loop W Ste 265
Houston, TX 77054-5636

Mailing address

8511 S Sam Houston Pkwy E
Suite 101
Houston, TX 77075-4874
Phone (713) 343-2301

Other identifiers 1

IdentifierTypeStateIssuer
217286803MedicaidTX

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
I20101104001498 TX Practitioner - Nurse Practitioner 2567373129 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trumen Physician and Associates Post Acute PLLCGroup PAC ID 5496236788, 127 clinicians
Trumen Physicians and Associates PLLCGroup PAC ID 7618006883, 133 clinicians

Practice addresses (Care Compare)

2626 S Loop W
Suite 265
Houston, TX 77054-5636
Phone (713) 796-9955

7887 Cambridge St
Houston, TX 77054-2013
Phone (713) 796-2777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
666178TXMDAdult Health Nurse Practitioner
AP117709TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA CurrentSince Jun 1, 2016 Accepting new patients
Trumen Physicians and Associates PLLC CurrentSince Jun 1, 2017 Accepting new patients
Geriatric Associates of America-Texas, PLLC Adult Health Past Accepting new patients

Locations

999 Raintree Cir
Allen, TX 75013
Phone (972) 390-8088

7887 Cambridge St
Houston, TX 77054
Phone (713) 796-2777

2626 S Loop W
Ste 265
Houston, TX 77054
Phone (713) 796-9955

6800 Preston Rd
Plano, TX 75024
Phone (214) 473-3634

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1134433113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 S SAM HOUSTON PKWY E",
            "address_2": "SUITE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770754874",
            "telephone_number": "713-343-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 S LOOP W STE 265",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545636",
            "telephone_number": "713-796-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOLA",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "666178",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP117709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217286803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.