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1497474373
MANGA TELIDEVARA
MONTGOMERY, TX
NPI
1497474373
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1090732)
Enumeration Date
2022-08-24
Last Update Date
2022-08-24
Business Address
Ms. MANGA TELIDEVARA NP
615 WORSHAM ST
MONTGOMERY, TX 77316-4497
Phone number: 281-650-0945
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Mailing Address
Ms. MANGA TELIDEVARA NP
615 WORSHAM ST
MONTGOMERY, TX 77316-4497
Phone number: 281-650-0945
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