Provider Demographics
NPI:1578175477
Name:NGALE, MOSES NJUMA
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:NJUMA
Last Name:NGALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N RESLER DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7029
Mailing Address - Country:US
Mailing Address - Phone:915-584-1359
Mailing Address - Fax:
Practice Address - Street 1:890 N RESLER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7029
Practice Address - Country:US
Practice Address - Phone:915-584-1359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist