Individual provider Active NPI

Abosede Comfort Adedapo, NP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1639780406
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1005212 Issued in TX
Practice address
12805 Cullen Blvd
Houston, TX 77047-3759
Phone
(832) 370-6513
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1005212TXMDFamily Nurse Practitioner

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1005212 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

12805 Cullen Blvd
Houston, TX 77047-3759

Mailing address

2915 Red Cardinal LN
Missouri City, TX 77459-6965
Phone (904) 962-0533

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 13, 2020.

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1639780406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 RED CARDINAL LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774596965",
            "telephone_number": "904-962-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 CULLEN BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770473759",
            "telephone_number": "832-370-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDAPO",
        "first_name": "ABOSEDE",
        "middle_name": "COMFORT",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1005212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.