Provider Demographics
NPI:1043936578
Name:CLAGUE, BIRGIT (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:BIRGIT
Middle Name:
Last Name:CLAGUE
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11914 ASTORIA BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6047
Mailing Address - Country:US
Mailing Address - Phone:713-486-1160
Mailing Address - Fax:281-922-1019
Practice Address - Street 1:11914 ASTORIA BLVD STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6047
Practice Address - Country:US
Practice Address - Phone:713-486-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1025085363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care