Provider Demographics
NPI:1922350925
Name:MCMONIGLE, JOHN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:MCMONIGLE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 SAWDUST RD
Mailing Address - Street 2:APT 2108
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2145
Mailing Address - Country:US
Mailing Address - Phone:513-403-4328
Mailing Address - Fax:
Practice Address - Street 1:13635 MICHEL RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6410
Practice Address - Country:US
Practice Address - Phone:281-351-7261
Practice Address - Fax:281-351-2515
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant