Provider Demographics
NPI:1225787971
Name:JAGOTA, AGAM BRAHMADI (DO)
Entity Type:Individual
Prefix:DR
First Name:AGAM
Middle Name:BRAHMADI
Last Name:JAGOTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 MOURSUND ST STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3405
Mailing Address - Country:US
Mailing Address - Phone:713-797-7429
Mailing Address - Fax:713-486-0966
Practice Address - Street 1:1333 MOURSUND ST STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3405
Practice Address - Country:US
Practice Address - Phone:713-797-7429
Practice Address - Fax:713-486-0966
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program