Individual
MOURINE ARA-EBANGA NDIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 CROWNHILL BLVD STE 300, SAN ANTONIO, TX 78209-1128
(210) 824-5530
(210) 824-5323
Mailing address
125 BISON LN, CIBOLO, TX 78108-3763
(256) 468-9514
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318094
TX
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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