Provider Demographics
NPI:1407242100
Name:NAGY, ANDREW JARED
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JARED
Last Name:NAGY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N SAN SABA STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3164
Mailing Address - Country:US
Mailing Address - Phone:210-615-6626
Mailing Address - Fax:
Practice Address - Street 1:8115 DATAPOINT DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3745
Practice Address - Country:US
Practice Address - Phone:210-615-6626
Practice Address - Fax:210-477-0279
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT76622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery