Provider Demographics
NPI:1437464385
Name:NAGI, SUNITA KAUR (PA)
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:KAUR
Last Name:NAGI
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:PO BOX 630823
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0136
Mailing Address - Country:US
Mailing Address - Phone:214-673-5484
Mailing Address - Fax:
Practice Address - Street 1:3109 6TH AVE STE B
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-3800
Practice Address - Country:US
Practice Address - Phone:682-312-7339
Practice Address - Fax:817-288-0958
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06871363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217770102Medicaid
TX217770101Medicaid
TX217770103Medicaid
TX217770103Medicaid
TXTXB120730Medicare PIN
TXTXB112825Medicare PIN