MR. ADEGBOYEGA OMOBA


Address: 1406 Anglican Drive, Arlington, TX 76002
Phone: 8177048116

MR. ADEGBOYEGA OMOBA (NPI# 1144713611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144713611
Entity Type Individual
Full Name MR. ADEGBOYEGA OMOBA
Credential PMHNP-BC
Practice Address 1406 Anglican Drive
Arlington
TX 76002
Mailing Address 1406 Anglican Dr
Arlington
TX 76002-3741
Practice Telephone 8177048116
Mailing Telephone 8177048116
Enumeration Date 2018-06-11
Last Update Date 2018-08-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 840719 TX Nursing Service Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
AP137736 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1406 ANGLICAN DRIVE
City ARLINGTON
State TX
Zip Code 76002

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1831441898 Nupur Merchant Occupational Therapist 7100 Matlock Rd., Arlington, TX 76002 2012-10-15
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1467786905 Olaniyi Samuel Adeoye Registered Nurse 8209 San Jose Street, Arlington, TX 76002 2009-10-01
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1497390694 Ijeoma Esther Osuji Nurse Practitioner 5307 Alta Vista Lane, Arlington, TX 76017 2019-11-12
1194367813 Agather Onyango Nurse Practitioner 725 Sendero Dr, Arlington, TX 76002-5715 2019-10-14
1710535398 Ebelechukwu Ekwenugo Nurse Practitioner 616 Jagera Way, Arlington, TX 76002-4582 2019-08-28
1427514553 Fast Behavorial Health Corporation Nurse Practitioner 1406 Anglican Dr, Arlington, TX 76002-3741 2019-02-13
1184129157 Perfect Peace Health Consultants Pllc Nurse Practitioner 1401 Gilday Dr, Arlington, TX 76002-3734 2018-03-29
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Competitor

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City ARLINGTON
Zip Code 76002

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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