Individual
STEPHEN M MBOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
2626 S LOOP W STE 265, HOUSTON, TX 77054-5636
(713) 796-9955
Mailing address
8511 S SAM HOUSTON PKWY E, SUITE 101, HOUSTON, TX 77075-4874
(713) 343-2301
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
666178
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP117709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217286803
—
TX
Enumeration date
08/02/2010
Last updated
07/28/2022
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