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:
Health care specialties
| Specialty | Code | License # | 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 8 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 | 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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