Individual
KHOTWANAEYA A MWAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2231 W GENTRY PKWY, TYLER, TX 75702-2809
(903) 535-9041
(903) 787-5098
Mailing address
523 S FANNIN AVE, TYLER, TX 75702-8204
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
49873
AZ
208000000X
Pediatrics Physician
Primary
R6634
TX
Other
Enumeration date
06/13/2012
Last updated
05/13/2025
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