Provider Demographics
NPI:1124006069
Name:NAGORSKI, LEONARD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:EDWARD
Last Name:NAGORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4356
Mailing Address - Street 2:DEPARTMENT 667
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4356
Mailing Address - Country:US
Mailing Address - Phone:281-586-3888
Mailing Address - Fax:281-440-2028
Practice Address - Street 1:9850 EMMETT F LOWRY EXPY STE C103
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2000
Practice Address - Country:US
Practice Address - Phone:409-938-2234
Practice Address - Fax:409-938-2200
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE145662085R0202X
TXM27222085R0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12135977OtherCAQH
TX181119201Medicaid
TX12135977OtherCAQH
8G7055Medicare Oscar/Certification