Individual
MICHAEL MOKUA OMBONGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 590-8000
Mailing address
214 SANTA FE TRL APT 2056, IRVING, TX 75063-7101
(281) 466-9577
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1085886
TX
Other
Enumeration date
06/18/2022
Last updated
11/11/2022
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