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General NPI Number Information
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NPI Number | 1447498019
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Entity Type | Organization
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Legal Business Name | MANGWIRO AND ASSOCIATES PLLC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 4321 N BELT LINE RD STE 500
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City | MESQUITE
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State | TX
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Zip | 75150-3133
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Country | US
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Telephone | 214-206-8904
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Fax | 214-206-8502
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Provider Business Mailing Address
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Address Line | 4321 N BELT LINE RD STE 500
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City | MESQUITE
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State | TX
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Zip | 75150-3133
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Country | US
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Telephone | 214-206-8904
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Fax | 214-206-8502
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Authorized Official
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Title or Position | OWNER
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Name | AUDREY N MANGWIRO
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Credential | MD
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Telephone | 214-206-8904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 051977
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License Number State | TX
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