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General NPI Number Information
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NPI Number | 1629482377
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Entity Type | Individual
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Provider Name | STELLA NAMUWONGE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 8144 WALNUT HILL LN STE 1120
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City | DALLAS
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State | TX
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Zip | 75231-4388
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Country | US
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Telephone | 214-313-9693
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Fax | 214-450-3651
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Provider Business Mailing Address
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Address Line | 5511 LINDEN ROSE LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-7113
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Country | US
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Telephone | 832-605-6745
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Fax |
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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 | 125455
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License Number State | TX
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