Individual
MR. GREGORY LEE MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4868 BEECHNUT ST, HOUSTON, TX 77096
(713) 664-6677
(713) 664-7096
Mailing address
4868 BEECHNUT ST, HOUSTON, TX 77096
(713) 664-6677
(713) 664-7096
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0607
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0607
LISCENCE
TX
05
—
121579003
—
TX
01
—
J0084884
DPS
TX
Enumeration date
10/13/2006
Last updated
03/07/2023
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