Provider Demographics
NPI:1447063227
Name:NWABINWE, STANLEY
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:NWABINWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 SEDONA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6285
Mailing Address - Country:US
Mailing Address - Phone:919-758-5207
Mailing Address - Fax:
Practice Address - Street 1:8110 SEDONA RIDGE DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6285
Practice Address - Country:US
Practice Address - Phone:919-758-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily