Provider Demographics
NPI:1750325288
Name:MONGA, NARINDER K (MD)
Entity Type:Individual
Prefix:DR
First Name:NARINDER
Middle Name:K
Last Name:MONGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:PAVILION 1 - SUITE 165
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-942-0881
Mailing Address - Fax:214-942-5035
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAVILION 1 - SUITE 165
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-942-0881
Practice Address - Fax:214-942-5035
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF6290208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1990OtherBC/BS
TX8R1990OtherBC/BS
TXB24966Medicare UPIN