MEDICARE: GLADYS NGU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1113684	TX

General Provider Information

NPI Number	:	1336623883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADYS NGU

Provider Business Mailing Address
First Line	:	1009 MANCHESTER DR
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098-1197
Country	:	US
Telephone Number	:	443-622-6336
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 PUNJAB WAY STE 140
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-1272
Country	:	US
Telephone Number	:	443-622-6336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	05/05/2026

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Directions to “ GLADYS NGU ” Practice Location

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