Individual provider Active NPI

Vivian Ebube

  • Registered Nurse
  • Katy, TX
National Provider Identifier
1487110078
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
950786 Issued in TX
Practice address
20511 Serringdon Dr
Katy, TX 77449-6149
Phone
(346) 970-8492
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 950786 TX Primary

Addresses

Primary practice location

20511 Serringdon Dr
Katy, TX 77449-6149

Mailing address

20511 Serringdon Dr
Katy, TX 77449-6149
Phone (346) 970-8492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
950786TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1487110078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20511 SERRINGDON DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496149",
            "telephone_number": "346-970-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20511 SERRINGDON DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496149",
            "telephone_number": "346-970-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBUBE",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "950786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.