Provider Demographics
NPI:1073186110
Name:NJOKU-GUS, AUGUSTINA CYNTHIA
Entity Type:Individual
Prefix:
First Name:AUGUSTINA
Middle Name:CYNTHIA
Last Name:NJOKU-GUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 HALSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3108
Mailing Address - Country:US
Mailing Address - Phone:713-482-9595
Mailing Address - Fax:
Practice Address - Street 1:1826 HALSTEAD ST
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3108
Practice Address - Country:US
Practice Address - Phone:713-482-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1025841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily