Provider Demographics
NPI:1538609227
Name:SESAY-MBAYO, AMINATA (NP)
Entity type:Individual
Prefix:MRS
First Name:AMINATA
Middle Name:
Last Name:SESAY-MBAYO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11715 GRIMALDI ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4515
Mailing Address - Country:US
Mailing Address - Phone:713-517-8682
Mailing Address - Fax:
Practice Address - Street 1:11715 GRIMALDI ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-4515
Practice Address - Country:US
Practice Address - Phone:713-517-8682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133314363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner