Most Relevant Information
Provider Data
| NPI Number: | 1003054057 |
| Provider Name: | NGALE NDIVA MONGOH PHARM.D |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 46316 |
Most Important Dates
| Enumeration Date: | 01/29/2009 |
| Last Updated: | 01/29/2009 |
Provider Practice Location
325 S. HWY. 35 BY PASS
PORT LAVACA
TX
77979
Practice Location Phone/Fax
| Phone: | 3615527486 |
| Fax: |
Provider Mailing Location
609 MALLETTE DR
# 525
VICTORIA
TX
779043382
Provider Mailing Phone/Fax
| Phone: | 3615720777 |
| Fax: |