Individual provider Active NPI

Agha Fongoh Mayah, LNN

  • Licensed Vocational Nurse
  • Houston, TX
National Provider Identifier
1407334196
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
342277 Issued in TX
Practice address
2818 Stoney Wood Dr
Houston, TX 77082-2040
Phone
(346) 400-8202
NPI assigned
Aug 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 342277 TX Primary

Addresses

Primary practice location

2818 Stoney Wood Dr
Houston, TX 77082-2040

Mailing address

2818 Stoney Wood Dr
Houston, TX 77082-2040
Phone (346) 400-8202

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

LicenseStateTypeSpecialty
342277TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1407334196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 STONEY WOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822040",
            "telephone_number": "346-400-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 STONEY WOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822040",
            "telephone_number": "346-400-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYAH",
        "first_name": "AGHA",
        "middle_name": "FONGOH",
        "credential": "LNN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "342277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.

Verify at the official NPI Registry.