Individual provider Active NPI

Janice Bangsal Cobo, FNP-C

  • Family Nurse Practitioner
  • League City, TX
National Provider Identifier
1356064604
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1089328 Issued in TX
Practice address
4420 W Main St
League City, TX 77573-1737
Phone
(832) 632-8803
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1089328 TX Primary

Addresses

Primary practice location

4420 W Main St
League City, TX 77573-1737

Mailing address

1065 Gladstone Dr
League City, TX 77573-9087
Phone (210) 867-0109

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
I20221013002890 TX Practitioner - Nurse Practitioner 1658747720 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ucp Physicians of Central Texas, PLLCGroup PAC ID 3173697935, 99 clinicians

Practice addresses (Care Compare)

1202 Nasa Pkwy
Houston, TX 77058-3304
Phone (281) 335-0606

1240 E Palm Valley Blvd
Round Rock, TX 78664-3202
Phone (512) 733-9100

1331 Northpark Dr
Kingwood, TX 77339-1636
Phone (281) 359-5330

2705 Broadway St
Suite 101
Pearland, TX 77581-4915
Phone (281) 412-0508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1089328TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Providence Physician Associates CurrentSince Sep 15, 2022 Accepting new patients
Ucp Physicians of Central Texas, PLLC CurrentSince Aug 2, 2024 Accepting new patients
Brazos Medical Center Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

6302 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (832) 831-9094

6306 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (713) 732-4677

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

4420 W Main St
League City, TX 77573
Phone (832) 632-1015

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

Interoperability endpoints

  • Direct secure messaging: janice.cobofnp.p6@direct.nextcare.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1356064604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 GLADSTONE DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775739087",
            "telephone_number": "210-867-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 W MAIN ST",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775731737",
            "telephone_number": "832-632-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBO",
        "first_name": "JANICE",
        "middle_name": "BANGSAL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1089328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.