Mambo, Evelyn Tetang

Mambo, Evelyn Tetang is an individual health care provider with primary practice located at 20326 Bandera Lake Ln , Richmond TX 77407-1505. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mambo, Evelyn Tetang can be contacted via phone (513) 328-5034.

Contact Information

Primary practice address
20326 Bandera Lake Ln Richmond TX 77407-1505
Phone: (513) 328-5034
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 348189 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X API43791 Texas

Profile Details

NPI number 1528346855
LBN Legal business name Mambo, Evelyn Tetang
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2011
Last updated Nov 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528346855 NPPES
Texas MEDICAID 11416731

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