Fagan, Wayne A

Fagan, Wayne A is an individual health care provider with primary practice located at 4141 S. Staples Suite 300 , Corpus Christi TX 78411-2929. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Fagan, Wayne A can be contacted via phone (361) 882-5560.

Contact Information

Primary practice address
4141 S. Staples Suite 300 Corpus Christi TX 78411-2929
Phone: (361) 882-5560
Fax: (361) 882-6011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 45D0913782 Texas
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X J4105 Texas

Profile Details

NPI number 1942206180
LBN Legal business name Fagan, Wayne A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated May 16th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942206180 NPPES
Texas Other 86470Y BLUE CROSS
Texas Other 0040EE BLUE CROSS
Texas MEDICAID 080856001 BLUE CROSS
Texas Other 070017610 BLUE CROSS
Texas Other 1356536494 BLUE CROSS
Texas Other CK7292 BLUE CROSS

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