Provider Demographics
NPI:1093707721
Name:NUGENT, BARBARA A (MD PA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:NUGENT
Suffix:
Gender:F
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 MATLOCK RD
Mailing Address - Street 2:STE 105
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2920
Mailing Address - Country:US
Mailing Address - Phone:817-465-6664
Mailing Address - Fax:817-468-9289
Practice Address - Street 1:3125 MATLOCK RD
Practice Address - Street 2:STE 105
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2920
Practice Address - Country:US
Practice Address - Phone:817-465-6664
Practice Address - Fax:817-468-9289
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG8204207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B25204Medicare UPIN
TX0909480001Medicare NSC
TX00A51PMedicare PIN