Provider Demographics
NPI:1518677038
Name:NEJEDLIKOVA, BARBORA N/A
Entity Type:Individual
Prefix:
First Name:BARBORA
Middle Name:N/A
Last Name:NEJEDLIKOVA
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 1:1020 BRAND LN APT 1634
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5769
Mailing Address - Country:US
Mailing Address - Phone:405-886-3394
Mailing Address - Fax:
Practice Address - Street 1:308 S FRIENDSWOOD DR STE A110
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3988
Practice Address - Country:US
Practice Address - Phone:281-993-4072
Practice Address - Fax:281-993-8051
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1077878363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty