Individual provider Active NPI

Bolaji Fawundu

  • Acute Care Nurse Practitioner
  • Cypress, TX
National Provider Identifier
1184192940
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1042708 Issued in TX
Practice address
27800 Northwest Fwy
Cypress, TX 77433-5302
Phone
(346) 231-4628
Fax
(281) 644-8144
NPI assigned
Nov 8, 2018
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1042708 TX Primary
Registered Nurse 163W00000X 1042708 TX
Acute Care Nurse Practitioner 363LA2100X 26NJ00876500 NJ

Addresses

Primary practice location

27800 Northwest Fwy
Cypress, TX 77433-5302

Mailing address

930 Frostwood Dr Ste 2.200
Houston, TX 77024-2450
Phone (713) 338-4523

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
I20211208001360 TX Practitioner - Nurse Practitioner 1456697325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

18951 N Memorial Dr
Humble, TX 77338-4217
Phone (281) 540-8409

27800 Northwest Fwy
Cypress, TX 77433-5302
Phone (346) 231-5887

27800 NW Fwy 4201
Cypress, TX 77433-5302
Phone (346) 231-4628

27800 NW Fwy M2 562
Cypress, TX 77433-5302
Phone (346) 231-4495

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1042708TXMDRegistered Nurse
26NJ00876500NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group CurrentSince Dec 5, 2021 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

27800 NW Freeway
Ste 4201
Cypress, TX 77433
Phone (346) 231-4628

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

921 Gessner Rd
Ste 317
Houston, TX 77024
Phone (713) 242-3768

930 Frostwood Dr
Ste 2200
Houston, TX 77024

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1184192940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FROSTWOOD DR STE 2.200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242450",
            "telephone_number": "713-338-4523",
            "fax_number": "713-338-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 NORTHWEST FWY",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335302",
            "telephone_number": "346-231-4628",
            "fax_number": "281-644-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWUNDU",
        "first_name": "BOLAJI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1042708",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1042708",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00876500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.