Provider Demographics
NPI:1942343090
Name:MANGLA, NARAIN D (MD)
Entity Type:Individual
Prefix:
First Name:NARAIN
Middle Name:D
Last Name:MANGLA
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 1:2601 HOSPITAL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1815
Mailing Address - Country:US
Mailing Address - Phone:361-883-8473
Mailing Address - Fax:361-883-8474
Practice Address - Street 1:2601 HOSPITAL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1815
Practice Address - Country:US
Practice Address - Phone:361-883-8473
Practice Address - Fax:361-883-8474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18730Medicare UPIN
TXOORX36Medicare ID - Type Unspecified