Individual
DIVYA MONGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1005 HARBORSIDE DR, GALVESTON, TX 77555-4500
(832) 505-2450
Mailing address
PO BOX 650859, DEPT 710, DALLAS, TX 75265
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
T1472
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06858549
—
MS
05
—
156987
—
AL
05
—
2393022
—
LA
01
—
P01620201
RAILROAD MEDICARE
MS
Enumeration date
07/14/2008
Last updated
03/06/2023
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