Provider Demographics
NPI:1831625433
Name:FUGUET, DANIEL ELIAS (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ELIAS
Last Name:FUGUET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 NORTHWEST FWY STE 540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6166
Mailing Address - Country:US
Mailing Address - Phone:407-223-4062
Mailing Address - Fax:
Practice Address - Street 1:1800 N CIVIC SQ STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2390
Practice Address - Country:US
Practice Address - Phone:928-813-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ682252085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty