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General NPI Number Information
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NPI Number | 1023728557
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Entity Type | Individual
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Provider Name | RICHARD SANKARA MUSONERA
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Gender | Male
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 1749 PINE ST
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City | ABILENE
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State | TX
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Zip | 79601-3043
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Country | US
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Telephone | 325-696-0600
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Fax | 325-676-3873
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Provider Business Mailing Address
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Address Line | 301 40TH ST
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City | LUBBOCK
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State | TX
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Zip | 79404-2746
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Country | US
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Telephone | 806-743-9355
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Fax | 806-743-9363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1099036
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License Number State | TX
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