Individual provider Active NPI

Mariam Opafunso, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1245183292
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1108056 Issued in TX
Practice address
11430 West Rd
Houston, TX 77065-4712
Phone
(507) 469-5303
NPI assigned
Feb 18, 2026
Last updated
Feb 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1108056 TX Primary

Addresses

Primary practice location

11430 West Rd
Houston, TX 77065-4712

Mailing address

11430 West Rd
Houston, TX 77065-4712

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
I20260603003318 TX Practitioner - Nurse Practitioner 4385115096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

8500 Village Dr
Suite 101
San Antonio, TX 78217-5510
Phone (726) 201-3047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1108056TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
21&US, LLC CurrentSince Oct 13, 2024 Accepting new patients
First Behavioral Health PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

11430 West Rd
Houston, TX 77065
Phone (346) 244-8836

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

NPI Registry JSON

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1245183292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11430 WEST RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 WEST RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654712",
            "telephone_number": "507-469-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPAFUNSO",
        "first_name": "MARIAM",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1108056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.