Healthcare Provider Details

I. General information

NPI: 1760732812
Provider Name (Legal Business Name): GEORGIA ANNA NAGEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 EAST RD ROOM 3236
HOUSTON TX
77054-6010
US

IV. Provider business mailing address

1711 OLD SPANISH TRL #438
HOUSTON TX
77054-1962
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-2571
  • Fax: 713-486-2565
Mailing address:
  • Phone: 713-548-4592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: