MEDICARE: BELITHA MUPANDASEKWA

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265937114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELITHA MUPANDASEKWA

Provider Business Mailing Address
First Line	:	18240 MIDWAY RD APT 505
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-4904
Country	:	US
Telephone Number	:	469-803-0756
Fax Number	:

Provider Business Practice Location Address
First Line	:	18240 MIDWAY RD APT 505
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-4904
Country	:	US
Telephone Number	:	469-803-0756
Fax Number	:

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

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	03/23/2018

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Directions to “ BELITHA MUPANDASEKWA ” Practice Location

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