Mbombo Mutambaie, is a
Licensed Vocational Nurse based in Hurst, Texas. Mbombo Mutambaie is licensed to practice in Texas (license number 187138) and her current practice location is
1822 Sotogrande Blvd Apt 1403, Hurst, Texas. She can be reached at her office (for appointments etc.) via phone at
(817) 939-0987.
NPI number for Mbombo Mutambaie is 1215411988 and her current mailing address is 1822 Sotogrande Blvd Apt 1403, Hurst, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215411988.
Provider's Profile
| Full Name | Mbombo Mutambaie |
|---|
| Gender | Female |
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| Speciality | Licensed Vocational Nurse |
|---|
| Location | 1822 Sotogrande Blvd Apt 1403, Hurst, Texas |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1215411988
- Provider Enumeration Date: 09/19/2018
- Last Update Date: 09/19/2018
Medical Identifiers
Medical identifiers for Mbombo Mutambaie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215411988 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164X00000X | Licensed Vocational Nurse | 187138 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mbombo Mutambaie is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mbombo Mutambaie,
1822 Sotogrande Blvd Apt 1403,
Hurst, TX 76053-8838
Ph: (817) 939-0987 | Mbombo Mutambaie,
1822 Sotogrande Blvd Apt 1403,
Hurst, TX 76053-8838
Ph: (817) 939-0987 |
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