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General NPI Number Information
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NPI Number | 1326560277
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Entity Type | Organization
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Legal Business Name | MANGO MEDICAL CARE PLLC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 3033 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77004-3258
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Country | US
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Telephone | 225-405-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 LEXINGTON GREEN DR
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City | MISSOURI CITY
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State | TX
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Zip | 77459-2834
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Country | US
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Telephone | 225-405-6717
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | HAO THI PHAM
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Credential | NP
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Telephone | 225-405-6717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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