Provider Demographics
NPI:1801521786
Name:JOIYEN MEDICAL, PLLC
Entity type:Organization
Organization Name:JOIYEN MEDICAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMORAGBON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:214-676-8711
Mailing Address - Street 1:4157 BEDFORD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5228
Mailing Address - Country:US
Mailing Address - Phone:469-949-6080
Mailing Address - Fax:
Practice Address - Street 1:4157 BEDFORD RD STE 200
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5228
Practice Address - Country:US
Practice Address - Phone:469-949-6080
Practice Address - Fax:972-634-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-23
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX449673901Medicaid