Provider Demographics
NPI:1730988478
Name:ADIMIBE, STELLA U
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:U
Last Name:ADIMIBE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10022 HALSTON DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2781
Mailing Address - Country:US
Mailing Address - Phone:832-620-7018
Mailing Address - Fax:
Practice Address - Street 1:10022 HALSTON DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2781
Practice Address - Country:US
Practice Address - Phone:832-620-7018
Practice Address - Fax:832-620-7015
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192453363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health