Dr. Ndubuisi David Odimegwu, AGNP-C
Nurse Practitioner, Gerontology in Houston, TX. Individual provider (NPI-1).
NPI number1043702467
StatusActive
Last updated in NPPESAug 11, 2024
Details
- NPI
- 1043702467
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ndubuisi David Odimegwu
- Credential
- AGNP-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2018
- Certification date
- Aug 11, 2024
- Last updated
- Aug 11, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | AP137648 | TX | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | AP137648 | TX | |
| 363LP2300X | Nurse Practitioner, Primary Care | AP137648 | TX |
Practice location
5530 W Ridgecreek Dr Ste 250Houston, TX 77053-3536
Phone 346-223-2195 · Fax 346-998-1550
Mailing address
1934 Plum Creek LnMissouri City, TX 77489-4165
Phone 651-353-9736
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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