Provider Demographics
NPI:1316407083
Name:MWATHI, ERNEST N (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:N
Last Name:MWATHI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 ARAPAHO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7900
Mailing Address - Country:US
Mailing Address - Phone:469-543-6993
Mailing Address - Fax:
Practice Address - Street 1:2630 ARAPAHO RD STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7900
Practice Address - Country:US
Practice Address - Phone:469-543-6993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1075652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily