HENRIETTA EBOMAH MD NPI 1598330854

NPI Information

NPI: 1598330854
Provider Name: HENRIETTA EBOMAH, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
11937 US HIGHWAY 271
TYLER, TX
ZIP 75708
Phone: (903) 877-7777
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Henrietta Ebomah, MD is a student in an organized health care education training program in Tyler, TX. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Henrietta Ebomah, MD NPI is 1598330854. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11937 US HIGHWAY 271
TYLER, TX
ZIP 75708-154
Phone: (903) 877-7777

The enumeration date for this NPI number is 5/20/2021 and was last updated on 5/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program		BP10075217	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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