Provider Demographics
NPI:1508490616
Name:MWAPE, THETIWE ZULU
Entity Type:Individual
Prefix:
First Name:THETIWE
Middle Name:ZULU
Last Name:MWAPE
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 1:813 RUGBY
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5003
Mailing Address - Country:US
Mailing Address - Phone:903-944-4753
Mailing Address - Fax:
Practice Address - Street 1:813 RUGBY
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-5003
Practice Address - Country:US
Practice Address - Phone:903-944-4753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX873097163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health