Provider Demographics
NPI:1023784709
Name:HLABANGANA, NOTHABO (CNP)
Entity type:Individual
Prefix:
First Name:NOTHABO
Middle Name:
Last Name:HLABANGANA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 MILLENIUM PARK PL
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1681
Mailing Address - Country:US
Mailing Address - Phone:469-774-0353
Mailing Address - Fax:
Practice Address - Street 1:16515 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2310
Practice Address - Country:US
Practice Address - Phone:281-980-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1038055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner