Provider Demographics
NPI:1508072679
Name:NGO, EDWARD K (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:K
Last Name:NGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2840 LEGACY DR
Mailing Address - Street 2:BLDG. 400
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6049
Mailing Address - Country:US
Mailing Address - Phone:972-712-3652
Mailing Address - Fax:214-618-3614
Practice Address - Street 1:2840 LEGACY DR
Practice Address - Street 2:BLDG. 400
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6049
Practice Address - Country:US
Practice Address - Phone:972-712-3652
Practice Address - Fax:214-618-3614
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2010-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10025404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206303401Medicaid
TX8CC385OtherBCBSTX
TX8L19262Medicare PIN