MEDICARE: JENNIFER NAGEL PA-C

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	363AM0700X	Medical Physician Assistant	S0156819	TX

General Provider Information

NPI Number	:	1922255207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NAGEL PA-C

Provider Business Mailing Address
First Line	:	9710 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6209
Country	:	US
Telephone Number	:	866-607-7334
Fax Number	:	713-358-4801

Provider Business Practice Location Address
First Line	:	9710 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6209
Country	:	US
Telephone Number	:	713-647-5900
Fax Number	:

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

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	10/21/2009

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