Individual provider Active NPI

Nyajuok Ter Dup Wur, MD

  • Family Medicine Physician
  • Galveston, TX
National Provider Identifier
1164916391
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T3412 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555
Phone
(281) 614-1256
Fax
(281) 614-1587
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T3412 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265
Phone (409) 772-2222

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927001732 TX Practitioner - Family Practice 0244586733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

3023 Marina Bay Dr
Suite 101
League City, TX 77573-2882
Phone (409) 772-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T3412TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Sep 20, 2021 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Aug 15, 2021 Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

3023 Marina Bay Dr
Ste 101
League City, TX 77573
Phone (281) 334-0620

Interoperability endpoints

  • Direct secure messaging: nwurmd40388@direct.utmb.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1164916391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75265",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77555",
            "telephone_number": "281-614-1256",
            "fax_number": "281-614-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUR",
        "first_name": "NYAJUOK",
        "middle_name": "TER DUP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.