Basic Information
| Provider Information | |||||||||
| NPI: | 1013200518 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOGARTY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PATRICK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8140 N MOPAC EXPY STE 3-210 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787598862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123432292 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8140 N MOPAC EXPY STE 3-210 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123432292 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2011 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 5513 | GA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | BP20047389 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 30968 | OK | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207R00000X | BP1-0040910 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | Q4103 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.