Provider Demographics
NPI:1306347216
Name:MAUGER MEDICAL PC
Entity type:Organization
Organization Name:MAUGER MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:361-993-3917
Mailing Address - Street 1:6001 S STAPLES ST STE C
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2901
Mailing Address - Country:US
Mailing Address - Phone:361-993-3917
Mailing Address - Fax:
Practice Address - Street 1:6001 S STAPLES ST STE C
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2901
Practice Address - Country:US
Practice Address - Phone:361-993-3917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX3033111N00000X
TXAP131375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty