Organization Active NPI

Laurelle Family Health & Wellness Center PLLC

  • Family Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1497429526
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LAURELLE FAMILY HEALTH & WELLNESS CENTER PLLC
Practice address
2304 De Lee St Ste 200
Bryan, TX 77802-2815
Phone
(979) 431-5800
Fax
(979) 703-1361
NPI assigned
Aug 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Authorized official

Name
Catherine Nanyongo Manga, DR.NPI 1376942391
Title
Owner
Phone
(979) 224-1087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2304 De Lee St Ste 200
Bryan, TX 77802-2815

Mailing address

2304 De Lee St Ste 200
Bryan, TX 77802-2815
Phone (979) 431-5800

Other identifiers 1

IdentifierTypeStateIssuer
427006801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210803002341 TX Part B Supplier - Clinic/Group Practice 6103220843 Receives reassigned benefits from 1 practitioner
Practice locations: Bryan, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2252252Laurelle Family Health & Wellness Center2304 De Lee Street # 200, Bryan, TX 77802Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1497429526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 DE LEE ST STE 200",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022815",
            "telephone_number": "979-431-5800",
            "fax_number": "979-703-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 DE LEE ST STE 200",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022815",
            "telephone_number": "979-431-5800",
            "fax_number": "979-703-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELLE FAMILY HEALTH & WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "MANGA",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "NANYONGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-224-1087",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427006801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.