Provider Demographics
NPI:1053880211
Name:FOGWE, SAAGHE MMBI (FNP)
Entity type:Individual
Prefix:MRS
First Name:SAAGHE
Middle Name:MMBI
Last Name:FOGWE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8108 MODESTO DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-8545
Mailing Address - Country:US
Mailing Address - Phone:817-793-0742
Mailing Address - Fax:
Practice Address - Street 1:1475 HERITAGE PKWY STE 225
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2740
Practice Address - Country:US
Practice Address - Phone:817-453-7522
Practice Address - Fax:866-665-6659
Is Sole Proprietor?:No
Enumeration Date:2018-11-17
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF11180518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily