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General NPI Number Information
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NPI Number | 1902537517
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Entity Type | Individual
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Provider Name | ABEL BOKOSSA MUKETE
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 4424 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-9608
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Country | US
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Telephone | 956-322-5310
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Fax |
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Provider Business Mailing Address
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Address Line | 905 W SMITH DR APT 4
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City | PHARR
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State | TX
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Zip | 78577-0585
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Country | US
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Telephone | 281-912-8747
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | NULL
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