Provider Demographics
NPI:1962462655
Name:NGO, KHANH NGOC (MD)
Entity Type:Individual
Prefix:MR
First Name:KHANH
Middle Name:NGOC
Last Name:NGO
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 1:8955 HIGHWAY 6 N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2320
Mailing Address - Country:US
Mailing Address - Phone:281-859-2334
Mailing Address - Fax:281-859-2343
Practice Address - Street 1:8955 HIGHWAY 6 N
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2320
Practice Address - Country:US
Practice Address - Phone:281-859-2334
Practice Address - Fax:281-859-2343
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160396101Medicaid
TXH90882Medicare UPIN