Provider Demographics
NPI:1952748238
Name:NGU, JULIUS N (MD, MPHIL,CCS,)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:N
Last Name:NGU
Suffix:
Gender:M
Credentials:MD, MPHIL,CCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E DANIELDALE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2014
Mailing Address - Country:US
Mailing Address - Phone:469-868-6250
Mailing Address - Fax:469-868-6256
Practice Address - Street 1:102 E DANIELDALE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-7216
Practice Address - Country:US
Practice Address - Phone:469-868-6250
Practice Address - Fax:469-868-6256
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73913208600000X
GA77097208D00000X
TXS5449208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR73913OtherARIZONA MEDICAL BOARD