Provider Demographics
NPI:1336641356
Name:OMONDI, DOROTHY NABWIRE (RN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:NABWIRE
Last Name:OMONDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:NABWIRE
Other - Last Name:OMONDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:2423 GLEN FIELD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7609
Mailing Address - Country:US
Mailing Address - Phone:512-545-3697
Mailing Address - Fax:
Practice Address - Street 1:7330 SAN PEDRO AVE # 800
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6235
Practice Address - Country:US
Practice Address - Phone:121-073-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX932155163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health