Provider Demographics
NPI:1457058554
Name:ONYEUGWOR, JOY (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:ONYEUGWOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:ONYEUGWOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:649 HUTCHINS DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-2749
Mailing Address - Country:US
Mailing Address - Phone:817-703-5445
Mailing Address - Fax:
Practice Address - Street 1:6029 BELT LINE RD STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7873
Practice Address - Country:US
Practice Address - Phone:855-893-5637
Practice Address - Fax:817-666-3873
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110432207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1110432OtherAPRN LICENSE