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General NPI Number Information
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NPI Number | 1992282818
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Entity Type | Individual
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Provider Name | PURITY MBURU
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Gender | Female
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 325 N SAINT PAUL ST STE 3100
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City | DALLAS
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State | TX
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Zip | 75201-3923
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Country | US
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Telephone | 469-905-4375
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 THICKET DR
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City | MANSFIELD
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State | TX
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Zip | 76063-6424
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Country | US
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Telephone | 682-410-5943
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 950102
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1167001
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License Number State | TX
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