Provider Demographics
NPI:1376945519
Name:WINGOOD, NYAMA (AC)
Entity Type:Individual
Prefix:
First Name:NYAMA
Middle Name:
Last Name:WINGOOD
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 AIROLE WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-3261
Mailing Address - Country:US
Mailing Address - Phone:512-954-2524
Mailing Address - Fax:
Practice Address - Street 1:2109 AIROLE WAY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-3261
Practice Address - Country:US
Practice Address - Phone:512-954-2524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist