Mamie Justine Kazala Cibangu

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

906154 Issued in TX

Practice address

3921 Carver PL
Irving, TX 75061-3910

Phone

(972) 258-5004

NPI assigned

Dec 10, 2018

Sex

Female

Sole proprietor

No

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1861963399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 CARVER PL",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750613910",
            "telephone_number": "214-908-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 CARVER PL",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750613910",
            "telephone_number": "972-258-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIBANGU",
        "first_name": "MAMIE JUSTINE",
        "middle_name": "KAZALA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "906154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chuchu
• Dipak Nanalal Chudasama, BDS, MSC, MORTH RCS
• Bilkish Chunara
• Diana Chung, D.D.S.
• Van Chung
• Cipm
• Paula Cipov, COTA/L
• Citrus-05 PLLC
• City of Irving
• Nicolas Civale

• All providers in Irving, TX
• Pediatric Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.