Individual
SIMBA K MUKETIWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 PARKHURST LANE, ALLEN, TX 75013
(469) 688-3437
Mailing address
104 PARKHURST LANE, ALLEN, TX 75013
(469) 688-3437
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP129372
TX
Other
Enumeration date
08/03/2015
Last updated
04/06/2022
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