Teresa Moraa Omboga X

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

345704 Issued in TX

Practice address

619 Sotogrande St
Grand Prairie, TX 75051-4456

Phone

(682) 331-2945

NPI assigned

Oct 1, 2019

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1497396501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 SOTOGRANDE ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514456",
            "telephone_number": "682-331-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 SOTOGRANDE ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514456",
            "telephone_number": "682-331-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMBOGA",
        "first_name": "TERESA",
        "middle_name": "MORAA",
        "name_suffix": "X",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "345704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olayinka Amazingrace Olojede, LVN
• Angela Olukitibi, PMHNP-BC
• Goddy Sunny Olunkwa, MHA
• Oluwaremilekun Rachel Oluwasegun
• Dekh Omar
• Omega Healthnest LLC (Omega Haven Care)
• Omega Healthnest LLC (Omega Thrive At-Home)
• Omni Housecalls LLC (Medical Housecalls)
• Omni Pain Clinic Inc
• Omolara Abitoye PA Dba Acclaim Pediatrics

• Licensed Vocational Nurse in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.