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General NPI Number Information
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NPI Number | 1467931147
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Entity Type | Individual
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Provider Name | ROGER BATISTA LAGO FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 7575 BELLAIRE BLVD APT 10E
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City | HOUSTON
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State | TX
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Zip | 77036-5007
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Country | US
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Telephone | 832-917-8549
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Fax |
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Provider Business Mailing Address
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Address Line | 302 W GULF BANK RD STE A
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City | HOUSTON
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State | TX
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Zip | 77037-2365
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Country | US
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Telephone | 832-917-8549
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1141103
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License Number State | TX
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