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General NPI Number Information
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NPI Number | 1326897034
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Entity Type | Individual
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Provider Name | JARED CHARLES SANGIORGI APRN
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Gender | Male
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 585-690-4402
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Fax |
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Provider Business Mailing Address
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Address Line | 401 WILDCAT RUN
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City | CIBOLO
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State | TX
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Zip | 78108-3636
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Country | US
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Telephone | 585-690-4402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 433112
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License Number State | NY
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