Provider Demographics
NPI:1598077075
Name:NGU, EDNA MANGWI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:MANGWI
Last Name:NGU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 PINECROFT DR
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3222
Mailing Address - Country:US
Mailing Address - Phone:281-466-3650
Mailing Address - Fax:281-466-3657
Practice Address - Street 1:9201 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3222
Practice Address - Country:US
Practice Address - Phone:281-466-3650
Practice Address - Fax:281-466-3657
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist