Individual
MR. PAUL W. BAGWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
(505) 454-2130
Mailing address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
(505) 454-2130
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0854
NM
Other
Enumeration date
01/23/2007
Last updated
07/22/2010
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