Individual provider Active NPI

Rfanyu Daisy Talla Ayuk Manyang

  • Family Nurse Practitioner
  • Katy, TX
National Provider Identifier
1528696416
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1166257 Issued in TX
Practice address
2111 Castle Gardens LN
Katy, TX 77449-1739
Phone
(832) 406-5720
NPI assigned
Mar 28, 2020
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1166257 TX
Family Nurse Practitioner 363LF0000X 1166257 TX Primary
Emergency Registered Nurse 163WE0003X 890474 TX

Addresses

Primary practice location

2111 Castle Gardens LN
Katy, TX 77449-1739

Mailing address

2111 Castle Gardens LN
Katy, TX 77449-1739
Phone (832) 406-5720

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
I20260504006835 TX Practitioner - Nurse Practitioner 6901374461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4110 Almeda Rd
Houston, TX 77004-9998

5446 Shamrock St
Houston, TX 77017-5630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
890474TXMDEmergency Registered Nurse
1166257TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Haven's Pediatric LLC CurrentSince Jun 28, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1528696416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CASTLE GARDENS LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774491739",
            "telephone_number": "832-406-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 CASTLE GARDENS LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774491739",
            "telephone_number": "832-406-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLA AYUK MANYANG",
        "first_name": "RFANYU",
        "middle_name": "DAISY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1166257",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1166257",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "890474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.