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General NPI Number Information
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NPI Number | 1568075265
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Entity Type | Organization
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Legal Business Name | AGNO HEALTH, LLP
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 08/24/2020
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Provider Practice Location Address
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Address Line | 2506 SOUTH LAMAR BLVD UNIT 2
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City | AUSTIN
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State | TX
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Zip | 78704-4731
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Country | US
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Telephone | 312-291-1219
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Fax | 512-271-4734
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Provider Business Mailing Address
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Address Line | 2223 WATERLOO CITY LN APT 323
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City | AUSTIN
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State | TX
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Zip | 78741-0008
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Country | US
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Telephone | 312-291-1219
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Fax | 512-271-4734
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Authorized Official
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Title or Position | OWNER/MD
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Name | JANE T HIMMELVO
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Credential | MD
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Telephone | 510-619-6872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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