Provider Demographics
NPI:1548549066
Name:SAGIS, PLLC
Entity type:Organization
Organization Name:SAGIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANGELOSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-697-2447
Mailing Address - Street 1:4131 DIRECTORS ROW
Mailing Address - Street 2:4131 DIRECTORS ROW
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8703
Mailing Address - Country:US
Mailing Address - Phone:877-697-2447
Mailing Address - Fax:855-697-2447
Practice Address - Street 1:4131 DIRECTORS ROW
Practice Address - Street 2:4131 DIRECTORS ROW
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8703
Practice Address - Country:US
Practice Address - Phone:877-697-2447
Practice Address - Fax:855-697-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB152208Medicare PIN