Provider Demographics
NPI:1336623883
Name:NGU, GLADYS
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:NGU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-1197
Mailing Address - Country:US
Mailing Address - Phone:443-622-6336
Mailing Address - Fax:
Practice Address - Street 1:4300 PUNJAB WAY STE 140
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1272
Practice Address - Country:US
Practice Address - Phone:443-622-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX934999163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse