Provider Demographics
NPI:1306577226
Name:BUZOMBO, ENIOLA (DNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ENIOLA
Middle Name:
Last Name:BUZOMBO
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 ALDINE MAIL RTE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-3804
Mailing Address - Country:US
Mailing Address - Phone:281-598-3300
Mailing Address - Fax:
Practice Address - Street 1:5230 ALDINE MAIL ROUTE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-3804
Practice Address - Country:US
Practice Address - Phone:281-598-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4704325738163WM0705X
MI4704325738163WM0705X
TX1023897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical