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NPI Code Detail

MEDICARE: JOHN ANGELO GNASSI MD

MEDICARE: JOHN ANGELO GNASSI MD
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
1207Q00000XFamily Medicine Physician74549MA

General Provider Information

NPI Number : 1629066105
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ANGELO GNASSI MD
Provider Business Mailing Address
First Line : 236 RAINBOW DR # 13625
Second Line :
City : LIVINGSTON
State : TX
Zip : 77399-2036
Country : US
Telephone Number : 857-210-3900
Fax Number :
Provider Business Practice Location Address
First Line : 12033 AGENCY RD
Second Line :
City : PARKER
State : AZ
Zip : 85344-7718
Country : US
Telephone Number : 928-669-2137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 08/11/2022

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Directions to “ JOHN ANGELO GNASSI MD” Practice Location

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