Individual provider Active NPI

Agnes Gwaro, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Alvin, TX
National Provider Identifier
1306325832
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP138102 Issued in TX
Practice address
1111 W Adoue St
Alvin, TX 77511-2718
Phone
(281) 824-1480
Fax
(281) 824-1480
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP138102 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP138102 TX Primary

Addresses

Primary practice location

1111 W Adoue St
Alvin, TX 77511-2718

Mailing address

8327 Kingsbridge Meadow Dr
Houston, TX 77083-7344
Phone (832) 488-4487

Other practice location 1

8327 Kingsbridge Meadow Dr
Houston, TX 77083-7344
Phone (832) 488-4487

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
I20191022002628 TX Practitioner - Nurse Practitioner 6002148103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

7026 Winterberry Glen LN
Katy, TX 77493-4687
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138102TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Oct 16, 2019 Accepting new patients
Brave Health Medical Group PA CurrentSince Jan 1, 2025 Accepting new patients
Stephen F Austin Community Health Center,Inc CurrentSince Oct 16, 2019 Accepting new patients

Locations

1951 NW 7th Ave
Ste 300
Miami, FL 33136
Phone (305) 699-3101

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

675 Town Square Blvd
Ste 200
Garland, TX 75040
Phone (305) 579-9538

Organizations & group practices 3

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1306325832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8327 KINGSBRIDGE MEADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770837344",
            "telephone_number": "832-488-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480",
            "fax_number": "281-824-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8327 Kingsbridge Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770837344",
            "country_code": "US",
            "telephone_number": "832-488-4487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWARO",
        "first_name": "AGNES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP138102",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP138102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alvin, TX

Sources for this page

Verify at the official NPI Registry.