Provider Demographics
NPI:1437338761
Name:MANGUERRA, MARIA GLENIA (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GLENIA
Last Name:MANGUERRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BARD DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-7501
Mailing Address - Country:US
Mailing Address - Phone:972-926-9868
Mailing Address - Fax:
Practice Address - Street 1:1201 BARD DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7501
Practice Address - Country:US
Practice Address - Phone:972-926-9868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX620829163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology