Provider Demographics
NPI:1326214586
Name:MONAGAS, JAVIER J (MD)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:J
Last Name:MONAGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:JAVIER
Other - Middle Name:JOSE
Other - Last Name:MONAGAS RIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 N. SANTA ROSA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3108
Mailing Address - Country:US
Mailing Address - Phone:210-704-2686
Mailing Address - Fax:210-704-2496
Practice Address - Street 1:333 N. SANTA ROSA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2686
Practice Address - Fax:210-704-2496
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD202049208000000X, 2080P0206X
TXP85112080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1097888Medicaid