Individual
IRENE IFEYINWA MBANASOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2203 W 35TH ST, AUSTIN, TX 78703-1203
(512) 454-4731
Mailing address
913 WINDSOR CASTLE DR, PFLUGERVILLE, TX 78660-7485
(512) 769-0071
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1207712
TX
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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