Healthcare Provider Details

I. General information

NPI: 1023419603
Provider Name (Legal Business Name): ANGELA RENEE NJOROGE MWANGI RT(R)(CT)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9441 LBJ FWY STE 602
DALLAS TX
75243-4545
US

IV. Provider business mailing address

9441 LBJ FWY STE 602
DALLAS TX
75243-4545
US

V. Phone/Fax

Practice location:
  • Phone: 469-249-1887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: