Provider Demographics
NPI:1588327126
Name:LIMCANGCO, ANGELO OCAMPO (BS)
Entity type:Individual
Prefix:
First Name:ANGELO
Middle Name:OCAMPO
Last Name:LIMCANGCO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 BELMERE LUXURY CT
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2966
Mailing Address - Country:US
Mailing Address - Phone:985-647-1505
Mailing Address - Fax:
Practice Address - Street 1:107 S HOLLYWOOD RD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2714
Practice Address - Country:US
Practice Address - Phone:985-876-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01460F208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation