MEDICARE: MISS LORIANE K NTANGA

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	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1740840156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LORIANE K NTANGA

Provider Business Mailing Address
First Line	:	2806 LACKECREST RIVER DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493
Country	:	US
Telephone Number	:	832-216-8157
Fax Number	:

Provider Business Practice Location Address
First Line	:	LACKECREST RIVER DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-7749
Country	:	US
Telephone Number	:	832-216-8157
Fax Number	:

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

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	06/18/2019

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Directions to “ MISS LORIANE K NTANGA ” Practice Location

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