MS. RENITA MADU (NPI# 1376774869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376774869 |
| Entity Type | Individual |
| Full Name | MS. RENITA MADU |
| Credential | P.A. |
| Practice Address |
12004 Shadow Creek Pkwy Suite 121 Pearland TX 77584-7326 |
| Practice Telephone | 2819689290 |
| Practice Fax Number | 2814631432 |
| Mailing Telephone | 2819689290 |
| Mailing Fax Number | 2814631432 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2013-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05780 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 111687302 | 05 |
| Street Address |
12004 SHADOW CREEK PKWY SUITE 121 |
| City | PEARLAND |
| State | TX |
| Zip Code | 77584-7326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181281 | Joyce Ann Fugit | Technician | 8024 Serenity Dr., Pearland, TX 77584 | 2020-10-16 |
| 1558916403 | Houston Mint Dentistry, Pllc | Dentist | 12568 Broadway St Ste 140, Pearland, TX 77584 | 2019-08-07 |
| 1982259198 | Pearland Unicare Pharmacy LLC | Pharmacy | 10970 Shadow Creek Parkway Suite 110.2, Pearland, TX 77584 | 2019-08-05 |
| 1972155869 | Parastoo Natasha Coselli | Dentist | 2811 Buisness Dr Unit 105, Pearland, TX 77584 | 2019-07-11 |
| 1679042030 | Dorothy B Smith-hubbard | Counselor | 919 Norfolk Dr., Pearland, TX 77584 | 2018-11-15 |
| 1720562499 | Kelly Jean Barba | Physical Therapy Assistant | 3406 Businesses Center Dr, Pearland, TX 77584 | 2018-09-19 |
| 1437631884 | Laura Gillet | Registered Nurse | 3306 Summerwood Lane, Pearland, TX 77584 | 2018-09-02 |
| 1881176204 | Sharry Magne Rivera Estrella | Registered Nurse | 11900 Shadow Creek Parkway Apt 1311, Pearland, TX 77584 | 2018-09-01 |
| 1962982264 | Shara Elizabeth Watts | Occupational Therapist | 12001 Shadow Creek Pwky, Pearland, TX 77584 | 2018-08-16 |
| 1457830861 | Melvin Thomas | Dentist | 3215 Souther Green Drive, Pearland, TX 77584 | 2018-08-08 |
| Find all providers in zip 77584 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437572161 | Leslie Anne Johnstone | Physician Assistant | 2750 Broadway St, Pearland, TX 77581-4905 | 2014-01-31 |
| 1508019969 | Lori Hess Jones | Physician Assistant | 2950 Cullen Blvd, Ste. 202, Pearland, TX 77584-3921 | 2008-10-29 |
| 1093737520 | Toni L Smith | Physician Assistant | 2950 Cullen Blvd, Suite 102, Pearland, TX 77584-3921 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
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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.