Fagan, Thomas
Fagan, Thomas is an sole proprietor health care provider with primary practice located at 2954 Rodeo Park Dr W , Santa Fe NM 87505-6351. He recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as his primary health care specialty. Fagan, Thomas can be contacted via phone (505) 424-0131.Contact Information
Primary practice address
2954 Rodeo Park Dr W
Santa Fe NM 87505-6351
Phone: (505) 424-0131
Fax: (505) 424-1299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Physical Therapy | 261QP2000X | #430 | New Mexico |
Profile Details
| NPI number | 1598878431 |
|---|---|
| LBN Legal business name | Fagan, Thomas |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Jun 7th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598878431 | NPPES |
| New Mexico | MEDICAID | N4536 |
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