Provider Demographics
NPI:1952118382
Name:NDIAYE, MAMADOU BABACAR (CHW,)
Entity type:Individual
Prefix:
First Name:MAMADOU
Middle Name:BABACAR
Last Name:NDIAYE
Suffix:
Gender:M
Credentials:CHW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7992 LOCKE LN APT 20
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3049
Mailing Address - Country:US
Mailing Address - Phone:832-971-1586
Mailing Address - Fax:
Practice Address - Street 1:7992 LOCKE LN APT 20
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3049
Practice Address - Country:US
Practice Address - Phone:832-971-1586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7691172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker