MEDICARE: CHARITY C MUGADZA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	L172456	IA
2	363LA2100X	Acute Care Nurse Practitioner	727383	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	727383	OTHER	TX	LICENSE NUMBER

General Provider Information

NPI Number	:	1568715514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY C MUGADZA NP

Provider Business Mailing Address
First Line	:	12300 FORD RD STE B425
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-7248
Country	:	US
Telephone Number	:	469-687-0039
Fax Number	:	469-687-0039

Provider Business Practice Location Address
First Line	:	7311 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	469-687-0039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	06/01/2026

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Directions to “ CHARITY C MUGADZA NP” Practice Location

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