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Contact Information

GREGORY L MANGUM, DPM
4868 BEECHNUT ST
HOUSTON, TX77096
 Phone: 713-664-6677
 Fax: 713-664-7096
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GREGORY L MANGUM · (Male)

NPI # 1336239359
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/13/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 0607
  • TX Medicaid 121579003
  • TX Other J0084884 DPS
  • TX Other 0607 LISCENCE
Hospital affiliation(s)
  • MEMORIAL HERMANN HOSPITAL SYSTEM - (Acute Care)
    1635 NORTH LOOP WEST
    HOUSTON, TX 77008
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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