MEDICARE: CHIPO NDLOVU PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	111337	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2W2675	OTHER	TX	MEDICARE

General Provider Information

NPI Number	:	1073215083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIPO NDLOVU PMHNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 4796
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78502-4796
Country	:	US
Telephone Number	:	956-570-5110
Fax Number	:	956-679-3040

Provider Business Practice Location Address
First Line	:	310 W NOLANA AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2528
Country	:	US
Telephone Number	:	956-570-5110
Fax Number	:	956-679-3040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	12/29/2025

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