Provider Demographics
NPI:1760732812
Name:NAGEL, GEORGIA ANNA (MD)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ANNA
Last Name:NAGEL
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 1:1711 OLD SPANISH TRL
Mailing Address - Street 2:#438
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1962
Mailing Address - Country:US
Mailing Address - Phone:713-548-4592
Mailing Address - Fax:
Practice Address - Street 1:1941 EAST RD
Practice Address - Street 2:ROOM 3236
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2571
Practice Address - Fax:713-486-2565
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program