Active NPI
Ngale Ndiva Mongoh, PHARM.D
- Pharmacist
- Port Lavaca, TX
National Provider Identifier
1003054057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46316
- Practice address
- 325 S. Hwy. 35 by Pass
Port Lavaca, TX 77979 - Phone
- (361) 552-7486
- NPI assigned
- Jan 29, 2009
- Last updated
- Jan 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46316 | TX | Primary |
Addresses
Primary practice location
325 S. Hwy. 35 by Pass
Port Lavaca, TX 77979
Mailing address
609 Mallette Dr
# 525
Victoria, TX 77904-3382
Phone (361) 572-0777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46316 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1003054057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 MALLETTE DR",
"address_2": "# 525",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779043382",
"telephone_number": "361-572-0777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 S. HWY. 35 BY PASS",
"city": "PORT LAVACA",
"state": "TX",
"postal_code": "77979",
"telephone_number": "361-552-7486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGOH",
"first_name": "NGALE",
"middle_name": "NDIVA",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "46316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Lavaca, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.