Organization
JEFF E HAGEN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF E HAGEN M.D. (OWNER)
(512) 304-0318
Entity
Organization
Contact information
Practice address
301 HIGHWAY 71 W, SUITE 111, BASTROP, TX 78602-4105
(512) 304-0318
(512) 308-9649
Mailing address
301 HIGHWAY 71 W, SUITE 111, BASTROP, TX 78602-4105
(512) 304-0318
(512) 308-9649
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G3424
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041869104
—
TX
Enumeration date
09/30/2011
Last updated
09/30/2011
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