Provider Demographics
NPI:1790078079
Name:BANGURA, LAMIN (MD)
Entity Type:Individual
Prefix:
First Name:LAMIN
Middle Name:
Last Name:BANGURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25511 BUDDE RD STE 2502
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2388
Mailing Address - Country:US
Mailing Address - Phone:832-616-5560
Mailing Address - Fax:
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1005
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8231
Practice Address - Country:US
Practice Address - Phone:281-888-0809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXFB7690515207RC0000X
TXR7950207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease