MEDICARE: BARBARA A NUGENT MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G8204	TX

General Provider Information

NPI Number	:	1093707721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A NUGENT MD PA

Provider Business Mailing Address
First Line	:	3125 MATLOCK RD
Second Line	:	STE 105
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2920
Country	:	US
Telephone Number	:	817-465-6664
Fax Number	:	817-468-9289

Provider Business Practice Location Address
First Line	:	3125 MATLOCK RD
Second Line	:	STE 105
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2920
Country	:	US
Telephone Number	:	817-465-6664
Fax Number	:	817-468-9289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/06/2010

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