Organization
EAGAN MEDICAL GROUP INC
Active
Organization
EAGAN MEDICAL GROUP INC
Active
Parent organization
EAGAN MEDICAL GROUP OF TEXAS, INC
Other names
Eagan Medical Group of Texas
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGAN MEDICAL GROUP OF TEXAS, INC
Authorized official
BREANNA SPLAIN (ADMINISTRATOR)
(714) 369-8037
Entity
Organization
Contact information
Practice address
8140 N MOPAC EXPY STE 150, AUSTIN, TX 78759-8837
(833) 766-5613
(512) 535-1413
Mailing address
8140 N MOPAC EXPY STE 150, AUSTIN, TX 78759-8837
(337) 665-6138
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G67163
MEDICAL LICENSE
CA
Enumeration date
04/12/2019
Last updated
04/27/2021
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