Provider Demographics
NPI:1669950978
Name:OSADEBAY, GLORIA (NURSE)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:OSADEBAY
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 DAFFODIL RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3295
Mailing Address - Country:US
Mailing Address - Phone:832-877-4242
Mailing Address - Fax:
Practice Address - Street 1:1507 DAFFODIL RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3295
Practice Address - Country:US
Practice Address - Phone:832-877-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX846639163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse