Individual provider Active NPI

Priscilla Gamboa, AGACNP

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1831657550
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
785168 Issued in TX
Practice address
10837 Katy Fwy Ste 250
Houston, TX 77079-2205
Phone
(713) 464-8099
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 785168 TX Primary

Addresses

Primary practice location

10837 Katy Fwy Ste 250
Houston, TX 77079-2205

Mailing address

19823 Ringwald CT
Spring, TX 77379-5059
Phone (713) 425-9249

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
I20200204001494 TX Practitioner - Nurse Practitioner 3476989823 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
785168TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pulmonary and Sleep Disorders Associates P a CurrentSince Oct 22, 2019 Accepting new patients

Locations

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

10837 Katy Fwy
Ste 250
Houston, TX 77079
Phone (713) 464-8099

701 S Fry Rd
Ste 225
Katy, TX 77450
Phone (713) 464-8099

Organizations & group practices 1

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": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1831657550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19823 RINGWALD CT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773795059",
            "telephone_number": "713-425-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10837 KATY FWY STE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792205",
            "telephone_number": "713-464-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "PRISCILLA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "785168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.