Provider Demographics
NPI:1063186724
Name:KANGETHE, MARY N (NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:N
Last Name:KANGETHE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3290 HAVENWOOD CHASE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6106
Mailing Address - Country:US
Mailing Address - Phone:832-798-5304
Mailing Address - Fax:
Practice Address - Street 1:4700 W SAM HOUSTON PKWY N STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-8224
Practice Address - Country:US
Practice Address - Phone:713-402-7824
Practice Address - Fax:713-570-0196
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2023-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1049284363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care