Provider Demographics
NPI:1770619496
Name:NANCY NGO MEDICAL GROUP LTD LLP
Entity type:Organization
Organization Name:NANCY NGO MEDICAL GROUP LTD LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:TING
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-722-3761
Mailing Address - Street 1:8333 9TH AVENUE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8151
Mailing Address - Country:US
Mailing Address - Phone:409-722-3761
Mailing Address - Fax:409-722-2095
Practice Address - Street 1:8333 9TH AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8151
Practice Address - Country:US
Practice Address - Phone:409-722-3761
Practice Address - Fax:409-722-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4171174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG53951Medicare UPIN