Individual provider Active NPI

Bongtin Agnes Lembvem, RN

  • Pediatric Registered Nurse
  • Katy, TX
National Provider Identifier
1649752304
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
822703 Issued in TX
Practice address
24630 Lakecrest Run Dr
Katy, TX 77493-2583
Phone
(240) 643-3236
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 822703 TX Primary

Addresses

Primary practice location

24630 Lakecrest Run Dr
Katy, TX 77493-2583

Mailing address

24630 Lakecrest Run Dr
Katy, TX 77493-2583
Phone (240) 643-3236

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
822703TXMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1649752304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 LAKECREST RUN DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932583",
            "telephone_number": "240-643-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24630 LAKECREST RUN DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932583",
            "telephone_number": "240-643-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMBVEM",
        "first_name": "BONGTIN",
        "middle_name": "AGNES",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "822703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.