Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 30968 | OK |
N | 207L00000X | Anesthesiologist | 5513 | GA |
N | 207L00000X | Anesthesiologist | BP20047389 | TX |
Y | 207L00000X | Anesthesiologist | Q4103 | TX |
N | 207R00000X | Internist | BP1-0040910 | TX |
N | 111NI0900X | Internist | BP1-0040910 | TX |
NPI | 1013200518 |
---|---|
Provider Name | Dr. James Patrick Fogarty JR. |
First Address | Austin, TX 78759-8862 |
Second Address | Austin, TX 78759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2011 |
Last Update Date | 18/03/2019 |