Individual provider Active NPI

Theresa Obonyano

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1548627268
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
783059 Issued in TX
Practice address
11476 Space Center Blvd
100
Houston, TX 77059-3599
Phone
(713) 486-6356
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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 783059 TX Primary

Addresses

Primary practice location

11476 Space Center Blvd
100
Houston, TX 77059-3599

Mailing address

11476 Space Center Blvd
100
Houston, TX 77059-3599

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
I20160809002827 TX Practitioner - Nurse Practitioner 6608160999 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
783059TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Linksview Home Healthcare & Wellness LLC Current Accepting new patients
Ut Physicians CurrentSince Aug 1, 2016 Accepting new patients
Ut Physicians CurrentSince Aug 1, 2016 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

11476 Space Center Blvd
Ste 100
Houston, TX 77059
Phone (713) 486-6325

6431 Fannin St
#4234
Houston, TX 77030
Phone (713) 500-6677

Interoperability endpoints

  • Direct secure messaging: theresa.obonyano.1@22307.direct.athenahealth.com
  • Direct secure messaging: tobonyano14809@direct.uth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1548627268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11476 SPACE CENTER BLVD",
            "address_2": "100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770593599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11476 SPACE CENTER BLVD",
            "address_2": "100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770593599",
            "telephone_number": "713-486-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBONYANO",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "783059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.