MEDICARE: DR. LEONARD EDWARD NAGORSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	14566	NE
2	2085R0202X	Diagnostic Radiology Physician	M2722	TX
3	208000000X	Pediatrics Physician	M2722	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12135977	OTHER	TX	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124006069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD EDWARD NAGORSKI M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 4356
Second Line	:	DEPARTMENT 667
City	:	HOUSTON
State	:	TX
Zip	:	77210-4356
Country	:	US
Telephone Number	:	281-586-3888
Fax Number	:	281-440-2028

Provider Business Practice Location Address
First Line	:	9850 EMMETT F LOWRY EXPY STE C103
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2000
Country	:	US
Telephone Number	:	409-938-2234
Fax Number	:	409-938-2200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	05/18/2023

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Directions to “ DR. LEONARD EDWARD NAGORSKI M.D.” Practice Location

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