Provider Demographics
NPI:1083916951
Name:NARAIN D. MANGLA, M.D., P.A.
Entity Type:Organization
Organization Name:NARAIN D. MANGLA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NARAIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MANGLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-883-8473
Mailing Address - Street 1:2601 HOSPITAL BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1888
Mailing Address - Country:US
Mailing Address - Phone:361-883-8473
Mailing Address - Fax:361-883-8457
Practice Address - Street 1:2601 HOSPITAL BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1888
Practice Address - Country:US
Practice Address - Phone:361-883-8473
Practice Address - Fax:361-883-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1949261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OORX36Medicare PIN