Provider Demographics
NPI:1679279467
Name:HUNT DUGO, ABIGAIL (PA)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HUNT DUGO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GRACY FARMS LN APT 1318
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2948
Mailing Address - Country:US
Mailing Address - Phone:315-651-1106
Mailing Address - Fax:
Practice Address - Street 1:1114 LOST CREEK BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6300
Practice Address - Country:US
Practice Address - Phone:512-379-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant