Provider Demographics
NPI:1801870522
Name:PUNAY, NESTOR CAGOL (MD)
Entity type:Individual
Prefix:
First Name:NESTOR
Middle Name:CAGOL
Last Name:PUNAY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2194 EASTEX FREEWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-4981
Mailing Address - Country:US
Mailing Address - Phone:409-347-1600
Mailing Address - Fax:409-347-1608
Practice Address - Street 1:2194 EASTEX FREEWAY
Practice Address - Street 2:SUITE A
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-4981
Practice Address - Country:US
Practice Address - Phone:409-347-1600
Practice Address - Fax:409-347-1608
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL98562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171114501Medicaid
TXI21187Medicare UPIN
TX171114501Medicaid