Healthcare Provider Details

I. General information

NPI: 1659747491
Provider Name (Legal Business Name): SIGISMUND S NJOGOPA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 01/05/2022
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HOLCOMBE BLVD
HOUSTON TX
77030-4000
US

IV. Provider business mailing address

PO BOX 4439
HOUSTON TX
77210-4439
US

V. Phone/Fax

Practice location:
  • Phone: 713-792-6161
  • Fax:
Mailing address:
  • Phone: 713-792-2991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number738721
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP128764
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: