Provider Demographics
NPI:1871136192
Name:AGUDA, HAZEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:HAZEL
Middle Name:
Last Name:AGUDA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 CAMPBELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4604
Mailing Address - Country:US
Mailing Address - Phone:713-467-2700
Mailing Address - Fax:713-467-3308
Practice Address - Street 1:1446 CAMPBELL RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4604
Practice Address - Country:US
Practice Address - Phone:713-467-2700
Practice Address - Fax:713-467-3308
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142179163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology