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General NPI Number Information
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NPI Number | 1639592926
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Entity Type | Individual
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Provider Name | MABLE PANKAJ AGNP & WHNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1534 N HAMPTON RD STE 100
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City | DESOTO
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State | TX
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Zip | 75115-2493
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Country | US
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Telephone | 682-405-1934
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Fax | 866-803-8759
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Provider Business Mailing Address
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Address Line | 1534 N HAMPTON RD STE 100
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City | DESOTO
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State | TX
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Zip | 75115-2493
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Country | US
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Telephone | 682-405-1934
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Fax | 866-803-8759
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 633575
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 633575
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License Number State | TX
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