Healthcare Provider Details

I. General information

NPI: 1588456388
Provider Name (Legal Business Name): ANTHONY JAMES NAGUIT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MAIN ST
FORT WORTH TX
76104-4917
US

IV. Provider business mailing address

1200 NOLAN RYAN EXPY APT 729
ARLINGTON TX
76011-5096
US

V. Phone/Fax

Practice location:
  • Phone: 855-768-6363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1214687
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: