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SOUTH TEXAS DERMATOLOGY PLLC NPI 1285903179


NPI Information

NPI: 1285903179
Provider Name: SOUTH TEXAS DERMATOLOGY PLLC

Other Name: WAYNE A FAGAN MD

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1300 THIRD STREET
CORPUS CHRISTI, TX
ZIP 78404
Phone: (361) 882-5560
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SOUTH TEXAS DERMATOLOGY PLLC is a specialist in Corpus Christi, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTH TEXAS DERMATOLOGY PLLC NPI is 1285903179. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Wayne A Fagan Md.

The provider's business location address is:

1300 THIRD STREET
CORPUS CHRISTI, TX
ZIP 78404
Phone: (361) 882-5560
Fax: (361) 882-6011

The provider's authorized official is Jennifer Lynn Vincent .
The authorized official title is Business Manager and has the following contact phone number (361) 882-2338.

The enumeration date for this NPI number is 12/21/2011 and was last updated on 12/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistJ4105TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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