FARIDY MAYA MOMBELEUR


Address: 2000 S Fm 51 Ste C, Decatur, TX 76234-3702
Phone: 9406261848

FARIDY MAYA MOMBELEUR (NPI# 1245790914) 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) 1245790914
Entity Type Individual
Full Name FARIDY MAYA MOMBELEUR
Practice Address 2000 S Fm 51 Ste C
Decatur
TX 76234-3702
Mailing Address 1816 S Fm 51 Ste 400
Decatur
TX 76234-3788
Practice Telephone 9406261848
Practice Fax Number 9406261849
Mailing Telephone 9406261848
Mailing Fax Number 9406261849
Enumeration Date 2019-03-20
Last Update Date 2019-08-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
AP140998 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX BCBSTX PENDING 01
TX PENDING 05

Office Location

Street Address 2000 S FM 51 STE C
City DECATUR
State TX
Zip Code 76234-3702

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477102028 Ursula Eileen Fernandez-plata Technician 1221 Cr 4371, Decatur, TX 76234 2019-09-06
1649772377 Stephanie Jennie Roddenberry Nurse Practitioner 2301 S Fm 51 Ste 500, Decatur, TX 76234 2018-03-08
1467731679 David Gatti Corless Dentist 301 W. Main St., Decatur, TX 76234 2011-08-05
1376830067 Cvs Pharmacy Inc Durable Medical Equipment & Medical Supplies 805 W Business Hwy 380, Decatur, TX 76234 2011-07-01
1356667844 Richard Ryan Ooten Specialist/Technologist, Other 239 Harvey Lane, Decatur, TX 76234 2010-04-09
1003049032 Advanced Gastroenterology Associates, Pa Internal Medicine 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 2009-08-25
1831346188 Rufus John Nelson Dentist 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 2008-08-19
1851558449 James Lee Hendrick Counselor 2304 Fm 51 South, Decatur, TX 76234 2008-05-21
1891964995 Sheryl A White Counselor 1106 E Business Hwy 380, Decatur, TX 76234 2008-02-22
1366625022 Tower Mutual Holding Company, Inc. Durable Medical Equipment & Medical Supplies 206 N. State Street, Decatur, TX 76234 2007-12-17
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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...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851934988 Tara Michelle Ridgeway Nurse Practitioner 2132 E Decatur St, Decatur, IL 62521-3148 2019-10-22
1891204152 Jasmine Keamber Mckinley Nurse Practitioner 1615 Kathy Ln Sw Ste 102, Decatur, AL 35603-1026 2017-09-29
1700305372 Jessica Skarda Nurse Practitioner 1577-1631 Kathy Ln Sw, Decatur, AL 35603 2017-09-14
1306477138 Obiageri Ohayagha Nurse Practitioner 445 Winn Way, Decatur, GA 30030-1707 2020-01-30
1407405905 Erica Y Taylor Nurse Practitioner 120 E Trinity Pl, Decatur, GA 30030-3302 2019-09-06
1205309267 Ashley M Garner Nurse Practitioner 320 E Central Ave, Decatur, IL 62521-4665 2019-01-02
1801379516 Lauren Colegrove Nurse Practitioner 465 Winn Way Ste 221, Decatur, GA 30030-1723 2018-09-09
1619459542 Okechukwu Nnaji Nurse Practitioner 445 Winn Way, Decatur, GA 30030-1707 2018-09-06
1235634635 Olubukola Funmi Olatoto Nurse Practitioner 445 Winn Way, Decatur, GA 30030 2018-03-27
1831693357 Bamidele Odede Nurse Practitioner 445 Winn Way, Decatur, GA 30030 2018-03-20
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Competitor

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City DECATUR
Zip Code 76234

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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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