Provider Demographics
NPI:1104376177
Name:NGOLE, RICHARD EKWOGE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EKWOGE
Last Name:NGOLE
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 AZURE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2471
Mailing Address - Country:US
Mailing Address - Phone:832-275-5412
Mailing Address - Fax:713-378-4477
Practice Address - Street 1:10900 KINGSPOINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4120
Practice Address - Country:US
Practice Address - Phone:713-378-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily