Provider Demographics
NPI:1639480536
Name:LANGDON, GINGER KAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:KAY
Last Name:LANGDON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 COUNTY ROAD 843
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-8559
Mailing Address - Country:US
Mailing Address - Phone:281-795-8339
Mailing Address - Fax:979-848-1859
Practice Address - Street 1:323 COUNTY ROAD 843
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-8559
Practice Address - Country:US
Practice Address - Phone:281-795-8339
Practice Address - Fax:979-848-1859
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146082172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker