Individual provider Active NPI

Obed Canjura

  • Community Health Worker
  • Houston, TX
National Provider Identifier
1679389290
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
12711 Issued in TX
Practice address
412 Telephone Rd
Houston, TX 77023-1840
Phone
(713) 660-1880
NPI assigned
Dec 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 12711 TX Primary

Addresses

Primary practice location

412 Telephone Rd
Houston, TX 77023-1840

Mailing address

412 Telephone Rd
Houston, TX 77023-1840
Phone (713) 660-1880

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
12711TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1679389290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 TELEPHONE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770231840",
            "telephone_number": "713-660-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 TELEPHONE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770231840",
            "telephone_number": "713-660-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANJURA",
        "first_name": "OBED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "12711",
            "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 Dec 9, 2024; 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.