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General NPI Number Information
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NPI Number | 1942479290
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Entity Type | Organization
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Legal Business Name | VIVEK MANGLA, MD PC
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 710 GASLIGHT BLVD STE A
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City | LUFKIN
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State | TX
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Zip | 75904-3187
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Country | US
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Telephone | 936-639-0988
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Fax | 936-639-0991
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Provider Business Mailing Address
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Address Line | 710 GASLIGHT BLVD STE A
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City | LUFKIN
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State | TX
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Zip | 75904-3187
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Country | US
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Telephone | 936-639-0988
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Fax | 936-639-0991
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. RHONDA THOMPSON
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Credential |
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Telephone | 936-639-0988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | K2237
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License Number State | TX
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