Provider Demographics
NPI:1609590868
Name:MUKANA, NSANIA
Entity Type:Individual
Prefix:
First Name:NSANIA
Middle Name:
Last Name:MUKANA
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 1:8007 ASHLEY CIRCLE DR S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3619
Mailing Address - Country:US
Mailing Address - Phone:832-443-7446
Mailing Address - Fax:
Practice Address - Street 1:806 S 75TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-4302
Practice Address - Country:US
Practice Address - Phone:713-926-8848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist