Provider Demographics
NPI:1275000325
Name:SANGAL, JOANNA GUTIERREZ (APRN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:GUTIERREZ
Last Name:SANGAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2323 WIRT RD STE F8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1232
Mailing Address - Country:US
Mailing Address - Phone:713-467-4900
Mailing Address - Fax:713-467-6006
Practice Address - Street 1:2323 WIRT RD STE F8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1232
Practice Address - Country:US
Practice Address - Phone:713-467-4900
Practice Address - Fax:713-467-6006
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX781365OtherTX RN
TXAP139489OtherAPRN
TX28270OtherRX AUTH