Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1630 | TX |
Y | 222Z00000X | Podiatrist | 1630 | TX |
NPI | 1003830241 |
---|---|
Provider Name | Lan D Ngo |
First Address | Houston, TX 77014-2047 |
Second Address | Houston, TX 77014-2047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |