Provider Demographics
NPI:1376066647
Name:GARCIA SAGNAY, CARLOS J
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:J
Last Name:GARCIA SAGNAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:JOSE
Other - Last Name:SAGNAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1000 W CANNON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3029
Mailing Address - Country:US
Mailing Address - Phone:817-896-5836
Mailing Address - Fax:
Practice Address - Street 1:605 NORTHWEST PKWY STE 2
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2942
Practice Address - Country:US
Practice Address - Phone:817-877-5858
Practice Address - Fax:817-335-4418
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5322207R00000X, 207RN0300X
FLTRN25544390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program