Provider Demographics
NPI:1790459360
Name:VOGEL, INDIRA (FNP)
Entity Type:Individual
Prefix:MS
First Name:INDIRA
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:INDIRA
Other - Middle Name:FAJARDO
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:3006 N RAUL LONGORIA RD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3006 N RAUL LONGORIA RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3676
Practice Address - Country:US
Practice Address - Phone:956-283-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily