Provider Demographics
NPI:1518065135
Name:DAGGUBATI, NAGESWARI K (MD)
Entity Type:Individual
Prefix:
First Name:NAGESWARI
Middle Name:K
Last Name:DAGGUBATI
Suffix:
Gender:F
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:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-1198
Mailing Address - Country:US
Mailing Address - Phone:325-670-4220
Mailing Address - Fax:325-670-4040
Practice Address - Street 1:1201 N 18TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2932
Practice Address - Country:US
Practice Address - Phone:325-793-3100
Practice Address - Fax:325-793-3195
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2677207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
895007OtherBCBS
TX122586403Medicaid
111170100OtherFIRSTCARE
060011941OtherRAILROAD MEDICARE
TX122586403Medicaid
B22120Medicare UPIN
895007Medicare ID - Type Unspecified
TX895007Medicare PIN