Bolanle Pickett
Individual provider Active NPI Registered Nurse · Katy, TX
NPI 1962036038 · NPPES record last updated Feb 27, 2020
Key facts
- NPI
- 1962036038
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 987465 (TX)
- Practice address
- 22618 Banter Point LN
Katy, TX 77449-5148 - Phone
- (832) 646-0174
- NPI assigned
- Feb 27, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 987465 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 987465 | TX | Yes |
Addresses
Primary practice location
22618 Banter Point LN
Katy, TX 77449-5148
Mailing address
1155 Dairy Ashford Rd Ste 560
Houston, TX 77079-3035
Phone (713) 799-2200
Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.