Provider Demographics
NPI:1447293881
Name:FOGEL, GUY R (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:R
Last Name:FOGEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-615-8600
Mailing Address - Fax:210-615-8605
Practice Address - Street 1:8042 WURZBACH RD
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3818
Practice Address - Country:US
Practice Address - Phone:210-615-8600
Practice Address - Fax:210-615-8605
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2012-02-29
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Provider Licenses
StateLicense IDTaxonomies
TXJ5322207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB143677OtherMEDICARE PTAN