Provider Demographics
NPI:1992340798
Name:OBAMONYI, MULEMU MWAPE
Entity type:Individual
Prefix:
First Name:MULEMU
Middle Name:MWAPE
Last Name:OBAMONYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 SIBYL LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-8501
Mailing Address - Country:US
Mailing Address - Phone:469-735-1414
Mailing Address - Fax:
Practice Address - Street 1:680 SIBYL LN
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-8501
Practice Address - Country:US
Practice Address - Phone:469-735-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health