Provider Demographics
NPI:1093321168
Name:ANGARITA, FERNANDO ANDRES (MD, MSC, FRCSC)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:ANDRES
Last Name:ANGARITA
Suffix:
Gender:M
Credentials:MD, MSC, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1661A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:346-238-5105
Mailing Address - Fax:346-238-0008
Practice Address - Street 1:6550 FANNIN ST STE 1661A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:346-238-5105
Practice Address - Fax:346-238-0008
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2310208600000X
NY302965208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery