Individual provider Active NPI

Mandy Marie Pugh

  • Obstetrics & Gynecology Nurse Practitioner
  • Nacogdoches, TX
National Provider Identifier
1306758347
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
1248043 Issued in TX
Practice address
2720 N University Dr
Nacogdoches, TX 75965-2938
Phone
(936) 305-5277
Fax
(936) 221-5225
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 1248043 TX
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 1248043 TX Primary

Addresses

Primary practice location

2720 N University Dr
Nacogdoches, TX 75965-2938

Mailing address

2720 N University Dr
Nacogdoches, TX 75965-2938
Phone (936) 305-5277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1306758347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652938",
            "telephone_number": "936-305-5277",
            "fax_number": "936-221-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652938",
            "telephone_number": "936-305-5277",
            "fax_number": "936-221-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MANDY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "1248043",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TX",
            "license": "1248043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.