Provider Demographics
NPI:1891922308
Name:NGASSA, KAMLO NELSON SR
Entity Type:Individual
Prefix:MR
First Name:KAMLO
Middle Name:NELSON
Last Name:NGASSA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 COMMERCE PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7497
Mailing Address - Country:US
Mailing Address - Phone:713-995-0944
Mailing Address - Fax:713-995-0933
Practice Address - Street 1:8700 COMMERCE PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7497
Practice Address - Country:US
Practice Address - Phone:713-995-0944
Practice Address - Fax:713-995-0933
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker