Provider Demographics
NPI:1568075265
Name:AGNO HEALTH, LLP
Entity Type:Organization
Organization Name:AGNO HEALTH, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HIMMELVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-619-6872
Mailing Address - Street 1:2223 WATERLOO CITY LN APT 323
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-0008
Mailing Address - Country:US
Mailing Address - Phone:312-291-1219
Mailing Address - Fax:512-271-4734
Practice Address - Street 1:2506 SOUTH LAMAR BLVD
Practice Address - Street 2:UNIT 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4731
Practice Address - Country:US
Practice Address - Phone:312-291-1219
Practice Address - Fax:512-271-4734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty