MEDICARE: DR. GWENDOLINE NGANKEU MENGA DO

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	207RR0500X	Rheumatology Physician	N8040	TX
2	207RR0500X	Rheumatology Physician	DO.000169	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8FD753	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447496047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GWENDOLINE NGANKEU MENGA DO

Provider Business Mailing Address
First Line	:	3068 COLLEGE PARK DR STE A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-8002
Country	:	US
Telephone Number	:	832-821-5550
Fax Number	:	936-207-4109

Provider Business Practice Location Address
First Line	:	3068 COLLEGE PARK DR STE A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-8002
Country	:	US
Telephone Number	:	832-821-5550
Fax Number	:	936-207-4109

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

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	12/24/2025

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Directions to “ DR. GWENDOLINE NGANKEU MENGA DO” Practice Location

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