IMELDA ALTJI PANGEMANAN GNP-BC NPI 1366722308

NPI Information

NPI: 1366722308
Provider Name: IMELDA ALTJI PANGEMANAN, GNP-BC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
1515 HOLCOMBE BLVD
HOUSTON, TX
ZIP 77030
Phone: (713) 792-6161
Get Directions

Imelda Altji Pangemanan, GNP-BC is a gerontology nurse practitioner in Houston, TX with 13 years of experience. Imelda Altji Pangemanan, GNP-BC NPI is 1366722308. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1515 HOLCOMBE BLVD
HOUSTON, TX
ZIP 77030-000
Phone: (713) 792-6161

The NPI 1366722308 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/23/2011 and was last updated on 12/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	721130	TEXAS	No
2	363LG0600X	Nurse Practitioner	Gerontology	AP120706	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	286527101	MEDICAID	TEXAS
2	286527102	MEDICAID	TEXAS
3	TXB140269	MEDICARE PIN	TEXAS
4	P01025636	OTHER	TEXAS	RAILROAD MEDICARE
5	859N14	OTHER	TEXAS	BCBS
6	346883YKQH	MEDICARE PIN	TEXAS
7	01609023	OTHER	TEXAS	AMERIGROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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