Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP135100 | TX |
NPI | 1003321688 |
---|---|
Provider Name | Ruth Ngindu |
First Address | Katy, TX 77494-7453 |
Second Address | Beaumont, TX 77706-7226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2017 |
Last Update Date | 12/04/2018 |