Individual
MICHAEL MWASUMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2201 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 526-7523
(254) 724-8572
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP113931
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009983085
—
AL
05
—
3634491
—
TN
05
—
74009333
—
KY
Enumeration date
09/22/2005
Last updated
01/26/2022
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