Provider Demographics
NPI:1891194304
Name:MINGALONE, RACHELA
Entity Type:Individual
Prefix:
First Name:RACHELA
Middle Name:
Last Name:MINGALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ROBINS LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7426
Mailing Address - Country:US
Mailing Address - Phone:956-639-6588
Mailing Address - Fax:
Practice Address - Street 1:14017 NW BLVD STE 107
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5140
Practice Address - Country:US
Practice Address - Phone:361-387-2000
Practice Address - Fax:361-387-2011
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80494237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
80494OtherHEARING AID FITTING AND DISPENSER