Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nang Immanivong

Individual provider Nurse Practitioner · NPI 1538567102

Nang Immanivong is a Nurse Practitioner in Houston, Texas. Qualified in 2014, 12 years ago. Practices with Villagemd of Southeast Texas PA, a 216-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
12
Licensed in
TX
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

1515 Holcombe Blvd
Houston, TX 77030-4009
Phone: (713) 792-6161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP126583 (TX)
Nurse Practitioner Taxonomy 363L00000X · Licence AP126583 / RN 732786 (TX)

Record details

NPI number1538567102
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 15, 2014
Last updated in NPPESMarch 1, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Villagemd Of Southeast Texas Pa — 216 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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