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Individual

CARA PENDERGAST NEAGOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
5303 HARRY HINES BLVD FL 8, DALLAS, TX 75390-4345
(214) 645-8650
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP134572
TX
363LA2200X
Adult Health Nurse Practitioner
AP134572
TX
363LG0600X
Gerontology Nurse Practitioner
AP134572
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1417470592
TX
Enumeration date
07/20/2017
Last updated
01/31/2019
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