Provider Demographics
NPI:1861162406
Name:TAJONG, NDELOKE LAUDUINE (NP)
Entity type:Individual
Prefix:
First Name:NDELOKE
Middle Name:LAUDUINE
Last Name:TAJONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N FAZIO WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-2701
Mailing Address - Country:US
Mailing Address - Phone:443-799-0028
Mailing Address - Fax:
Practice Address - Street 1:690 S LOOP 336 W STE 215
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3322
Practice Address - Country:US
Practice Address - Phone:936-828-3962
Practice Address - Fax:936-828-3967
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily