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NPI Code Detail

MEDICARE: JAMES K. SAMPOGNARO CRNA

MEDICARE: JAMES K. SAMPOGNARO CRNA
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
1367500000XCertified Registered Nurse Anesthetist553146TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770581571
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES K. SAMPOGNARO CRNA
Provider Business Mailing Address
First Line : 2220 FOREST HOLLOW PARK
Second Line :
City : DALLAS
State : TX
Zip : 75228-7825
Country : US
Telephone Number : 214-327-2271
Fax Number : 214-327-2271
Provider Business Practice Location Address
First Line : 4916 OVERTON PLZ
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4415
Country : US
Telephone Number : 888-804-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 12/06/2007

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