Individual provider Active NPI

Gordon Udeh

  • Registered Nurse
  • Dallas, TX
National Provider Identifier
1992604391
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1046289 Issued in TX
Practice address
13355 Noel Rd Ste 1100
Dallas, TX 75240-6694
Phone
(833) 400-0120
NPI assigned
Nov 2, 2026
Last updated
Nov 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1046289 TX Primary

Addresses

Primary practice location

13355 Noel Rd Ste 1100
Dallas, TX 75240-6694

Mailing address

1508 Monte Carlo Dr
Mansfield, TX 76063-6221
Phone (432) 270-7928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1992604391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 MONTE CARLO DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636221",
            "telephone_number": "432-270-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 NOEL RD STE 1100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406694",
            "telephone_number": "833-400-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDEH",
        "first_name": "GORDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1046289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.