Egret Bay Neurology, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

554544 Issued in TX

Legal business name

EGRET BAY NEUROLOGY, PA

Practice address

18333 Egret Bay Blvd
Suite 650
Houston, TX 77058-3860

Phone

(281) 333-9933

Fax

(281) 333-4072

NPI assigned

Nov 30, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mavis D Fujii, MDNPI 1013099399

Title

President

Phone

(281) 333-9933

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mavis D Fujii, M.D.

  • Neurology Physician
  • Houston, TX
  • NPI 1013099399
  NPD Authorized official
• Tia Renee Glenn, R.N., ANP

  • Adult Health Nurse Practitioner
  • Houston, TX
  • NPI 1396782538
  NPD (past)

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1750563748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18333 EGRET BAY BLVD",
            "address_2": "SUITE 650",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583860",
            "telephone_number": "281-333-9933",
            "fax_number": "281-333-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18333 EGRET BAY BLVD",
            "address_2": "SUITE 650",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583860",
            "telephone_number": "281-333-9933",
            "fax_number": "281-333-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGRET BAY NEUROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "FUJII",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-333-9933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "554544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0018MQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eghtedar Sadeghpour MD PA
• Brittany Egland
• Melissa Dawn Egland, LCSW
• Jacob Egly
• Egolink Express Inc (Egoexpress)
• Egret Inpatient Services, PLLC
• Adanma Egu
• Obiloh Egu, M.D.
• Justice Egualekhide
• Valerie Osayemwenre Eguasa, NP

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.