Provider Demographics
NPI:1265937114
Name:MUPANDASEKWA, BELITHA
Entity type:Individual
Prefix:
First Name:BELITHA
Middle Name:
Last Name:MUPANDASEKWA
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 1:18240 MIDWAY RD APT 505
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4904
Mailing Address - Country:US
Mailing Address - Phone:469-803-0756
Mailing Address - Fax:
Practice Address - Street 1:18240 MIDWAY RD APT 505
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-4904
Practice Address - Country:US
Practice Address - Phone:469-803-0756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health