Individual provider Active NPI

Clothilda Ekeanyanwu

  • Family Nurse Practitioner
  • Stafford, TX
National Provider Identifier
1417479536
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06172088 Issued in TX
Practice address
314 Wheelhouse CT
Stafford, TX 77477-5826
Phone
(281) 658-0116
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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 F06172088 TX Primary

Addresses

Primary practice location

314 Wheelhouse CT
Stafford, TX 77477-5826

Mailing address

314 Wheelhouse CT
Stafford, TX 77477-5826
Phone (281) 658-0116

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
I20200415000900 TX Practitioner - Nurse Practitioner 0840322590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8138 S Kirkwood Rd
Suite C
Houston, TX 77072-3724
Phone (832) 295-3571

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06172088TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Hispana Sinai CurrentSince Aug 23, 2025 Accepting new patients
Sumar Healthcare Services Inc PastSince Jan 11, 2010 Accepting new patients

Locations

8138 S Kirkwood Rd
Ste C
Houston, TX 77072
Phone (281) 933-3399

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1417479536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 WHEELHOUSE CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775826",
            "telephone_number": "281-658-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 WHEELHOUSE CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775826",
            "telephone_number": "281-658-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEANYANWU",
        "first_name": "CLOTHILDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F06172088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

Verify at the official NPI Registry.