Provider Demographics
NPI:1275270621
Name:AGUORU, PHOEBE (FNP-C)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:AGUORU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18729 CHRIGHTON CASTLE BND
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7579
Mailing Address - Country:US
Mailing Address - Phone:512-264-5939
Mailing Address - Fax:
Practice Address - Street 1:18729 CHRIGHTON CASTLE BND
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7579
Practice Address - Country:US
Practice Address - Phone:512-264-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056989363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty