Active NPI
Paul Deba Mango, LVN , CPR
- Licensed Vocational Nurse
- Dallas, TX
National Provider Identifier
1124519046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 343027
- Practice address
- 14100 Montfort Dr Apt 1154
Dallas, TX 75254-3073 - Phone
- (469) 324-6221
- NPI assigned
- May 25, 2018
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 343027 | TX | Primary |
Addresses
Primary practice location
14100 Montfort Dr Apt 1154
Dallas, TX 75254-3073
Mailing address
14100 Montfort Dr Apt 1154
Dallas, TX 75254-3073
Phone (469) 324-6221
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 343027 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1124519046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14100 MONTFORT DR APT 1154",
"city": "DALLAS",
"state": "TX",
"postal_code": "752543073",
"telephone_number": "469-324-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14100 MONTFORT DR APT 1154",
"city": "DALLAS",
"state": "TX",
"postal_code": "752543073",
"telephone_number": "469-324-6221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGO",
"first_name": "PAUL",
"middle_name": "DEBA",
"name_prefix": "Mr.",
"credential": "LVN , CPR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-25",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "343027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.