Individual
MABEL IBEWUIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7400 VINEYARD DR, PLANO, TX 75025-2547
(469) 685-7827
Mailing address
7400 VINEYARD DR, PLANO, TX 75025-2547
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
212466
TX
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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