Provider Demographics
NPI:1710537980
Name:ANYA, EBERE (NP)
Entity Type:Individual
Prefix:
First Name:EBERE
Middle Name:
Last Name:ANYA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EBERE
Other - Middle Name:
Other - Last Name:ULU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20710 BANDROCK TER
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1473
Mailing Address - Country:US
Mailing Address - Phone:832-573-4229
Mailing Address - Fax:
Practice Address - Street 1:4710 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4526
Practice Address - Country:US
Practice Address - Phone:346-901-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363LF0000XMedicaid