Provider Demographics
NPI:1427749779
Name:NILMAG, RONGCHAI SODCHUN (RN, BSN, VA-BC)
Entity type:Individual
Prefix:MR
First Name:RONGCHAI
Middle Name:SODCHUN
Last Name:NILMAG
Suffix:
Gender:M
Credentials:RN, BSN, VA-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 N ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80019-2221
Mailing Address - Country:US
Mailing Address - Phone:832-766-7726
Mailing Address - Fax:
Practice Address - Street 1:2600 N CENTRAL EXPY STE 280
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2057
Practice Address - Country:US
Practice Address - Phone:866-747-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1655188163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse