Individual provider Active NPI

Odette Tiranke Kourouma, NP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1134525868
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126172 Issued in TX
Practice address
14629 Memorial Dr
Houston, TX 77079-7500
Phone
(281) 589-8500
NPI assigned
Nov 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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 AP126172 TX Primary

Addresses

Primary practice location

14629 Memorial Dr
Houston, TX 77079-7500

Mailing address

14629 Memorial Dr
Houston, TX 77079-7500
Phone (281) 589-8500

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
I20160226001214 TX Practitioner - Nurse Practitioner 3577868611 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ucp Physicians of Central Texas, PLLCGroup PAC ID 3173697935, 99 clinicians
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

1240 E Palm Valley Blvd
Round Rock, TX 78664-3202
Phone (512) 733-9100

1331 Northpark Dr
Kingwood, TX 77339-1636
Phone (281) 359-5330

15320 Hwy 105 W
Suite 120
Montgomery, TX 77356-2602
Phone (936) 582-5660

3415 FM 762 Rd
Suite 180
Richmond, TX 77469-5580
Phone (281) 699-5680

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP126172TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Sep 12, 2022 Accepting new patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Doctors Express of the Beaumont Area PA CurrentSince Dec 11, 2021 Accepting new patients
Normandy Urgent Care Center PA CurrentSince Jan 22, 2020 Accepting new patients
Ucp Physicians of Central Texas, PLLC CurrentSince Sep 12, 2022 Accepting new patients
Advanced Practice House Calls LLC Family CurrentSince Sep 1, 2020 Accepting new patients
West Houston Medical Services CurrentSince Dec 12, 2015 Accepting new patients
Providence Physician Associates CurrentSince Aug 31, 2022 Accepting new patients
Brazos Medical Center Past Accepting new patients
Normandy Urgent Care Center PA Past Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients
Advance Pharmacy LLC Past Accepting new patients

Locations

596 E Stacy Rd
Allen, TX 75002
Phone (469) 898-0199

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

6600 S Mopac Expy
Ste 2180
Austin, TX 78749
Phone (512) 522-3010

8831 N Highway 146
Baytown, TX 77523
Phone (281) 533-8354

3195 Dowlen Rd
Ste 105
Beaumont, TX 77706
Phone (409) 860-1888

779 Normandy St
Ste 114
Houston, TX 77015
Phone (713) 453-8900

6340 N Eldridge Pkwy
Ste O
Houston, TX 77041
Phone (346) 385-9181

2646 S Loop W
Ste 330
Houston, TX 77054
Phone (281) 888-4407

14629 Memorial Dr
Houston, TX 77079
Phone (281) 589-8500

6302 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (832) 831-9094

9504 Long Point Rd
Ste E
Houston, TX 77055
Phone (713) 461-3535

6930 FM 1960 Rd W
Houston, TX 77069
Phone (713) 554-6300

6306 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (713) 732-4677

6445 FM 1463 Rd
Ste 230
Katy, TX 77494
Phone (281) 990-6890

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

8850 Spencer Hwy
La Porte, TX 77571
Phone (281) 946-9980

1921 W League City Pkwy
Ste 130
League City, TX 77573
Phone (281) 937-2590

3415 FM 762 Rd
Ste 180
Richmond, TX 77469
Phone (281) 699-5680

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

4724 Lakeview Pkwy
Ste 300
Rowlett, TX 75088
Phone (469) 947-6240

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Interoperability endpoints

  • Direct secure messaging: odette.kouroumafnp.p6@direct.nextcare.nextgenshare.com

Organizations & group practices 12

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": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1134525868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14629 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770797500",
            "telephone_number": "281-589-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14629 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770797500",
            "telephone_number": "281-589-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUROUMA",
        "first_name": "ODETTE",
        "middle_name": "TIRANKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.