Tshiala Bupola, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1044102 Issued in TX

Practice address

2924 Vicksburg LN
Fort Worth, TX 76123-1627

Phone

(518) 491-9384

NPI assigned

Jun 15, 2021

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1770151862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 VICKSBURG LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231627",
            "telephone_number": "518-491-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 VICKSBURG LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231627",
            "telephone_number": "518-491-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUPOLA",
        "first_name": "TSHIALA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1044102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Bullon
• John Bump, D.O.
• Ryan Lee Bumpas
• Scott A. Bundy, M.D.
• Donnisha Bunting
• Phillip T. Burch, MD
• Amelia Monica Burciu, CRNA
• Thomas Kevin Burdenski Jr., LIC. PSYCHOLOGIST
• Kelly Burdick, LCDC
• Walworth Edward Burge, MD

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.