MS. ELIZABETH MBULA WASONGA (NPI# 1215105762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215105762 |
| Entity Type | Individual |
| Full Name | MS. ELIZABETH MBULA WASONGA |
| Credential | LICENSED PROFESSIONA |
| Practice Address |
4102 Greenwood Way Mansfield TX 76063 |
| Practice Telephone | 6824223909 |
| Practice Fax Number | 6824223909 |
| Mailing Telephone | 6824223909 |
| Mailing Fax Number | 6824223909 |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2015-12-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
20115 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUECROSSBLUESHIELD PROV# | 88601L | 01 |
| TX | 193427501 | 05 |
| Street Address |
4102 GREENWOOD WAY |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592375 | Leonard Lamount Robinson | Counselor | 545 Bailey Dr, Mansfield, OH 44904-1801 | 2020-06-09 |
| 1770136921 | Cory Baker | Counselor | 305 Regency Pkwy Ste 601, Mansfield, TX 76063-7306 | 2019-07-17 |
| 1790256097 | Alice Elizabeth Ward | Counselor | 104 South Wisteria Street, Mansfield, TX 76063 | 2018-12-12 |
| 1891275939 | Mone't Smith | Counselor | 3251 Matlock Rd Apt 17204, Mansfield, TX 76063-5079 | 2018-08-17 |
| 1184117806 | Tiffanie Marquita Bembry | Counselor | 370 N State Highway 360 Apt 5207, Mansfield, TX 76063-9029 | 2018-06-07 |
| 1992207054 | Pediatric Counseling of Mansfield | Counselor | 404 E Broad St Ste 200, Mansfield, TX 76063-1728 | 2018-03-05 |
| 1407360787 | Dorothy Firth Smith | Counselor | 1285 N Main St Ste 101, Mansfield, TX 76063-1511 | 2017-11-26 |
| 1598275315 | Tina Marie Cole | Counselor | 63 3rd St Ste 103, Mansfield, PA 16933-1262 | 2017-10-06 |
| 1770093718 | Diana Gale Ham | Counselor | 1800 E Broad St, Annex C, Mansfield, TX 76063-3411 | 2017-10-04 |
| 1093238313 | Cara Pruitt | Counselor | 601 Strada Cir, Mansfield, TX 76063-3212 | 2017-07-18 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.