Provider Demographics
NPI:1952801466
Name:MWANGI, LILIAN WAMBUI
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:WAMBUI
Last Name:MWANGI
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 1:6100 OHIO DR APT 1826
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2626
Mailing Address - Country:US
Mailing Address - Phone:214-604-5741
Mailing Address - Fax:
Practice Address - Street 1:3309 TWIN DIAMOND CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-8118
Practice Address - Country:US
Practice Address - Phone:972-943-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317797164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse