Provider Demographics
NPI:1831807734
Name:NWABUISI, FRIDAY CHIDOZIE
Entity type:Individual
Prefix:
First Name:FRIDAY
Middle Name:CHIDOZIE
Last Name:NWABUISI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6412 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6969
Mailing Address - Country:US
Mailing Address - Phone:972-357-5763
Mailing Address - Fax:
Practice Address - Street 1:6412 CRYSTAL CT
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-6969
Practice Address - Country:US
Practice Address - Phone:972-357-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098616363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health