Evangelista C. Anugwom, RN

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

4128 Arbor CT
Mesquite, TX 75150

Phone

(214) 649-6048

Fax

(972) 677-7978

NPI assigned

Oct 18, 2011

Last updated

Oct 18, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1396020699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 ARBOR CT",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75150",
            "telephone_number": "214-649-6048",
            "fax_number": "972-677-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 ARBOR CT",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75150",
            "telephone_number": "214-649-6048",
            "fax_number": "972-677-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANUGWOM",
        "first_name": "EVANGELISTA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.