Provider Demographics
NPI:1881358307
Name:NDLOVU, DUMISANI
Entity type:Individual
Prefix:
First Name:DUMISANI
Middle Name:
Last Name:NDLOVU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2410
Mailing Address - Country:US
Mailing Address - Phone:972-639-7921
Mailing Address - Fax:
Practice Address - Street 1:3210 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2410
Practice Address - Country:US
Practice Address - Phone:972-639-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX894830163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse