Provider Demographics
NPI:1366448557
Name:NGO, NANCY T (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:T
Last Name:NGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 9TH AVE
Mailing Address - Street 2:STE C
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8083
Mailing Address - Country:US
Mailing Address - Phone:409-722-3761
Mailing Address - Fax:409-722-2095
Practice Address - Street 1:8333 9TH AVE
Practice Address - Street 2:STE C
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8083
Practice Address - Country:US
Practice Address - Phone:409-722-3761
Practice Address - Fax:409-722-2095
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2024-04-02
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
TXK41712080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine