Active NPI
Peter Ezieke
- Family Nurse Practitioner
- Sugar Land, TX
National Provider Identifier
1881474740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1130660
- Practice address
- 2808 Grants Lake Blvd Unit 302
Sugar Land, TX 77479-1345 - Phone
- (832) 600-4490
- NPI assigned
- Sep 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1130660 | TX | Primary |
Addresses
Primary practice location
2808 Grants Lake Blvd Unit 302
Sugar Land, TX 77479-1345
Mailing address
2808 Grants Lake Blvd Unit 302
Sugar Land, TX 77479-1345
Phone (832) 600-4490
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1130660 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1881474740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2808 GRANTS LAKE BLVD UNIT 302",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774791345",
"telephone_number": "832-600-4490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2808 GRANTS LAKE BLVD UNIT 302",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774791345",
"telephone_number": "832-600-4490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZIEKE",
"first_name": "PETER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-29",
"last_updated": "2023-09-29",
"certification_date": "2023-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1130660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.