Provider Demographics
NPI:1609430412
Name:OGUAYO, BEVERLY (NP-C)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:OGUAYO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10907 MEMORIAL HERMANN DR STE 320
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4194
Mailing Address - Country:US
Mailing Address - Phone:713-987-7760
Mailing Address - Fax:832-288-5837
Practice Address - Street 1:10907 MEMORIAL HERMANN DR STE 320
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4194
Practice Address - Country:US
Practice Address - Phone:713-987-7760
Practice Address - Fax:832-288-5837
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0419431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner