Mary O Adegborioye, PMHNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Missouri City, TX

NPI 1144868530 · NPPES record last updated Dec 16, 2019

Key facts

NPI
1144868530
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
32669 (TX)
Practice address
16407 Red Oak Dr
Missouri City, TX 77489-3909
Phone
(281) 935-3502
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
32669TXMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matoll Health Services Inc Current
since Dec 22, 2019
Accepting new patients

Locations

9800 Centre Pkwy
Ste 245
Houston, TX 77036
Phone (281) 935-3502

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 32669 TX
Adult Health Nurse Practitioner 363LA2200X 32669 TX
Community Health Nurse Practitioner 363LC1500X 32669 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 32669 TX Yes

Addresses

Primary practice location

16407 Red Oak Dr
Missouri City, TX 77489-3909

Mailing address

16407 Red Oak Dr
Missouri City, TX 77489-3909
Phone (281) 935-3502

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL HOUSTON Direct

Other providers in Missouri City, TX

All providers in Missouri City, TX · Psychiatric/Mental Health Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.