Provider Demographics
NPI:1770524142
Name:NARINDER K MONGA, MD, PA
Entity type:Organization
Organization Name:NARINDER K MONGA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARINDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:MONGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-942-0881
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:PAVILION 1 - SUITE 165
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-942-0881
Mailing Address - Fax:214-942-5035
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAVILION 1 - SUITE 165
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-942-0881
Practice Address - Fax:214-942-5035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0057MAOtherBC/BS
TX008234WMedicare PIN