Provider Demographics
NPI:1972282754
Name:NGOLE, VERA DEBIME
Entity Type:Individual
Prefix:MISS
First Name:VERA
Middle Name:DEBIME
Last Name:NGOLE
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 1:6732 VERDE APT 352
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3420
Mailing Address - Country:US
Mailing Address - Phone:601-397-9601
Mailing Address - Fax:
Practice Address - Street 1:6732 VERDE APT 352
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3420
Practice Address - Country:US
Practice Address - Phone:601-397-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1064081363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner