Provider Demographics
NPI:1366256711
Name:INGARGIOLA, MARY F (FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:INGARGIOLA
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:INGARGIOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:208 GREENSHADE LN
Mailing Address - Street 2:
Mailing Address - City:CADDO MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:75135-6580
Mailing Address - Country:US
Mailing Address - Phone:850-686-4864
Mailing Address - Fax:
Practice Address - Street 1:4101 WESLEY ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5635
Practice Address - Country:US
Practice Address - Phone:903-454-8111
Practice Address - Fax:903-455-7779
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF02250024207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine