Provider Demographics
NPI:1275838740
Name:JOSE E PAGAN, M.D., P.A.
Entity type:Organization
Organization Name:JOSE E PAGAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-993-1640
Mailing Address - Street 1:4833 SARATOGA BLVD
Mailing Address - Street 2:PMB 295
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2213
Mailing Address - Country:US
Mailing Address - Phone:361-993-1640
Mailing Address - Fax:361-985-2065
Practice Address - Street 1:5934 S STAPLES ST
Practice Address - Street 2:SUITE 230
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3859
Practice Address - Country:US
Practice Address - Phone:361-993-1640
Practice Address - Fax:361-985-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK09742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty