Provider Demographics
NPI:1083178164
Name:MWAURA-GATHUNGU, BERNICE W
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:W
Last Name:MWAURA-GATHUNGU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 ENCLAVE PKWY APT 211
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3635
Mailing Address - Country:US
Mailing Address - Phone:253-227-6853
Mailing Address - Fax:
Practice Address - Street 1:1502 ENCLAVE PKWY APT 211
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3635
Practice Address - Country:US
Practice Address - Phone:253-227-6853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX915846163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics