Provider Demographics
NPI:1326066358
Name:NWEKE, GLORIA UCHEBUNMA
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:UCHEBUNMA
Last Name:NWEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:GLORIA
Other - Middle Name:UCHEBUNMA
Other - Last Name:NWEKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3435 HIGHLAND RD STE 105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-7165
Mailing Address - Country:US
Mailing Address - Phone:972-686-4209
Mailing Address - Fax:972-686-3825
Practice Address - Street 1:3435 HIGHLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7165
Practice Address - Country:US
Practice Address - Phone:972-686-4209
Practice Address - Fax:972-686-3825
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457969Medicare Oscar/Certification