Individual provider Active NPI

Ekaterina Aldonza Tangog, DO

  • General Practice Physician
  • Jbsa-Fort Sam Houston, TX
National Provider Identifier
1336998855
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
3092 Issued in NE
Practice address
Brooke Army Medical Center, McHe-MDX
Internal Medicine Residency, 3551 Roger Brooke Dr.
Jbsa-Fort Sam Houston, TX 78234-4504
Phone
(210) 292-3410
Fax
(210) 292-7868
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 3092 NE Primary

Addresses

Primary practice location

Brooke Army Medical Center, McHe-MDX
Internal Medicine Residency, 3551 Roger Brooke Dr.
Jbsa-Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 292-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216000633 NE Order and Referring Only - NeurologyPractitioner - Neurology 8729572847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3092NEMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1336998855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-292-3410",
            "fax_number": "210-292-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER, MCHE-MDX",
            "address_2": "INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR.",
            "city": "JBSA-FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-292-3410",
            "fax_number": "210-292-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGOG",
        "first_name": "EKATERINA",
        "middle_name": "ALDONZA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "3092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa-Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.