Provider Demographics
NPI:1235611872
Name:BANGURA, ROSALINE KING
Entity Type:Individual
Prefix:
First Name:ROSALINE
Middle Name:KING
Last Name:BANGURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12034 HUNTINGTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3206
Mailing Address - Country:US
Mailing Address - Phone:832-277-4216
Mailing Address - Fax:
Practice Address - Street 1:12034 HUNTINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3206
Practice Address - Country:US
Practice Address - Phone:832-277-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX940548163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse