JEFF L PUGACH (NPI# 1871589978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871589978 |
Entity Type | Individual |
Full Name | JEFF L PUGACH |
Credential | MD |
Practice Address |
750 8th Ave Fl 6 Fort Worth TX 76104-2515 |
Mailing Address |
Po Box 99371 Fort Worth TX 76199-0371 |
Practice Telephone | 6823030376 |
Practice Fax Number | 6823030377 |
Mailing Telephone | (682) 885-1855 |
Mailing Fax Number | 6828857347 |
Enumeration Date | 2005-09-23 |
Last Update Date | 2017-08-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
L3077 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 144459805 | 05 | |
TX | MEDICAID OTHER | 144459806 | 01 |
TX | 144459807 | 05 | |
TX | 144459803 | 05 | |
TX | 144459804 | 05 |
Street Address |
750 8TH AVE FL 6 |
City | FORT WORTH |
State | TX |
Zip Code | 76104-2515 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871136390 | Tessa Shambaugh | Nurse Practitioner | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2019-10-28 |
1508284027 | Lauren Mecke | Nurse Practitioner | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2014-04-01 |
1457517500 | Kala Ann Bright | Nurse Practitioner | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2008-07-29 |
1700048964 | Jonathan David Kaye | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2008-06-30 |
1487622734 | William G Reiner | Psychiatry & Neurology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2006-03-12 |
1760479513 | Kirk J Pinto | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2005-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
Find all providers in zip 76104 |
Taxonomy Code | 2088P0231X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
Specialization | Pediatric Urology |
Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700048964 | Jonathan David Kaye | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2008-06-30 |
1760479513 | Kirk J Pinto | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2005-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932543246 | Dung Pham | Urology | 1200 Binz St Ste 690, Houston, TX 77004-6943 | 2013-04-18 |
1679702377 | Andrew John Marks | Urology | 4499 Medical Dr Ste 360, San Antonio, TX 78229-3857 | 2009-07-02 |
1780719997 | Mohammad A Sami | Urology | 26019 Juniper Stone Ln, Katy, TX 77494-2615 | 2007-02-21 |
1659455616 | Lawrence J. Cisek | Urology | 6410 Fannin St Ste 950, Houston, TX 77030-5204 | 2006-10-25 |
1366411803 | Warren Thomas Snodgrass | Urology | 5680 Frisco Square Blvd Ste 2300, Frisco, TX 75034 | 2006-03-16 |
1063044881 | Crescent Medical Institute Pllc | Urology | 1200 Binz St Ste 690, Houston, TX 77004-6943 | 2020-02-10 |
1033652425 | Pediatric Urology of San Antonio Pllc | Urology | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2016-12-02 |
1619383650 | Pediatric and Adult Reconstructive Center for Urology, Pllc | Urology | 5680 Frisco Square Blvd, Suite 2300, Frisco, TX 75034-3308 | 2014-07-10 |
1326337874 | Matthew David Timberlake | Urology | 3601 4th St Stop 7260, Lubbock, TX 79430-0816 | 2011-04-06 |
1154641546 | Gaayana Raju | Urology | 4499 Medical Dr Ste 360, San Antonio, TX 78229-3857 | 2010-06-08 |
Find all providers with the same taxonomy |
City | FORT WORTH |
Zip Code | 76104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.