Provider Demographics
NPI:1184052888
Name:BONAVENTURE NGU, M.D., PLLC
Entity type:Organization
Organization Name:BONAVENTURE NGU, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONAVENTURE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-697-2111
Mailing Address - Street 1:1485 FM 1960 BYPASS RD E
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3964
Mailing Address - Country:US
Mailing Address - Phone:281-913-5204
Mailing Address - Fax:281-913-5718
Practice Address - Street 1:1485 FM 1960 BYPASS RD E
Practice Address - Street 2:SUITE 360
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3964
Practice Address - Country:US
Practice Address - Phone:281-913-5204
Practice Address - Fax:281-913-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3339207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty