1902908155 NPI number — MRS. ANGELINA L KENG DC

Table of content: MRS. ANGELINA L KENG DC (NPI 1902908155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902908155 NPI number — MRS. ANGELINA L KENG DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENG
Provider First Name:
ANGELINA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902908155
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4418 CENTER
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
DEER PARK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-542-0300
Provider Business Mailing Address Fax Number:
281-542-0464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4418 CENTER
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
DEER PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-542-0300
Provider Business Practice Location Address Fax Number:
281-542-0464
Provider Enumeration Date:
09/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC6566 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 82420Y . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com