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General NPI Number Information
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NPI Number | 1003568452
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Entity Type | Individual
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Provider Name | JONATHON THAI NGO PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 4660 SWEETWATER BLVD STE 190
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City | SUGAR LAND
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State | TX
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Zip | 77479-3164
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Country | US
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Telephone | 713-777-4785
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Fax |
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Provider Business Mailing Address
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Address Line | 11111 NEXUS AVE APT 1116
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City | STAFFORD
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State | TX
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Zip | 77477-1559
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Country | US
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Telephone | 832-541-4359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | TX
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