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Individual
PETER ALEXIS KANGOS
Active
Individual
PETER ALEXIS KANGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G4020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742864140
TAX ID
TX
Enumeration date
08/31/2006
Last updated
11/19/2010
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