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Individual
DR. VIKTOR YETIMOVICH KAGAN
Active
Individual
DR. VIKTOR YETIMOVICH KAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168675001
—
TX
05
—
168675002
—
TX
01
—
86918A
BLUE CROSS BLUE SHIELD
TX
01
—
P00140372
RAIL ROAD
TX
Enumeration date
06/17/2006
Last updated
08/09/2007
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