ESONGNYUO FOMUKONG-ETTA (NPI# 1255886909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255886909 |
| Entity Type | Individual |
| Full Name | ESONGNYUO FOMUKONG-ETTA |
| Credential | NP |
| Practice Address |
3050 Regent Blvd Ste 100 Irving TX 75063-3107 |
| Mailing Address |
Po Box 9755 Houston TX 77213-0755 |
| Practice Telephone | 2146898076 |
| Mailing Telephone | 8327172780 |
| Mailing Fax Number | 8327172781 |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2020-03-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP131427 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3050 REGENT BLVD STE 100 |
| City | IRVING |
| State | TX |
| Zip Code | 75063-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083057830 | Leah C Brake | Nurse Practitioner | 3050 Regent Blvd Ste 100, Irving, TX 75063-3107 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386288868 | Fiesta Lifecare Pharmacy 8 LLC | Pharmacy | 412 E Riley St, Freer, TX 75063 | 2019-10-29 |
| 1013578491 | Bobbie Snow Masenda | Nurse Practitioner | 6161 N Sh 161 Service Rd, Unit 200, Irving, TX 75063 | 2019-06-26 |
| 1164989620 | Ellen Green | Occupational Therapist | 7701 Las Colinas Ridge Suite 110, Irving, TX 75063 | 2019-02-20 |
| 1417412503 | Heda Enterprises, Pllc | Optometrist | 2400 Martket Place Blvd, # 180, Irving, TX 75063 | 2019-02-04 |
| 1861956542 | Hannah Kennedy | Specialist/Technologist | 8249 Ranchview Dr Apt 3087, Irving, TX 75063 | 2019-01-26 |
| 1447732805 | Ziprad Inc | Clinic/Center | 7750 N Macarthur Blvd Ste 120-365, Irving, TX 75063 | 2018-09-02 |
| 1457831646 | Laura Robinson | Specialist/Technologist | 8641 Mill Creek Rd, Irving, TX 75063 | 2018-08-16 |
| 1457845208 | Padmaja Jagdish Ambre | Nurse Practitioner | 516, Raton Pass, Irving, TX 75063 | 2018-06-15 |
| 1407394588 | Optum Infusion Services 500, Inc. | Pharmacy | 8400 Esters Blvd Ste 185, Rm 119, Irving, TX 75063 | 2017-02-08 |
| 1376086561 | Mika Claire Smith | Social Worker | 1175 Kinwest Pky, #100, Irving, TX 75063 | 2016-11-21 |
| Find all providers in zip 75063 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013578491 | Bobbie Snow Masenda | Nurse Practitioner | 6161 N Sh 161 Service Rd, Unit 200, Irving, TX 75063 | 2019-06-26 |
| 1770148421 | Ashily Susan Skaria | Nurse Practitioner | 1618 Skyview Dr, Irving, TX 75060-4712 | 2019-05-08 |
| 1932628831 | Justus Mogaka | Nurse Practitioner | 4604 W Pioneer Dr Apt 347, Irving, TX 75061-3845 | 2017-09-12 |
| 1861862245 | Nicole Crooks | Nurse Practitioner | 4250 Club House Cir, Apartment 2229, Irving, TX 75038-9093 | 2015-09-29 |
| 1205107273 | Sylviane Akenda Kasende | Nurse Practitioner | 2925 Skyway Circle N, Irving, TX 75038 | 2012-01-23 |
| 1356618748 | Elisabeth Anne Buchanan | Nurse Practitioner | 5605 N. Macarthur Bl., #400, Irving, TX 75038-2617 | 2011-11-29 |
| 1083857809 | Bibi S Koo | Nurse Practitioner | 3050 Regent Blvd., Suite 200, Irving, FL 75063 | 2009-04-09 |
| 1619981784 | Melissa Demasi | Nurse Practitioner | 3501 N Macarthur Blvd Ste 360, Irving, TX 75062-3621 | 2006-07-27 |
| 1437126703 | Christine M Acker | Nurse Practitioner | 3050 Regent Blvd Ste 200, Irving, TX 75063-5806 | 2006-03-04 |
| 1881680650 | Diana Joyce Mcmains | Nurse Practitioner | 3050 Regent Blvd. Suite 200, Examination Management Services, Irving, TX 75063 | 2005-09-27 |
| Find all providers in IRVING | ||||
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| 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.