Individual
MICHAEL BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
950 N 14TH ST, BEAUMONT, TX 77702-1111
(409) 898-6485
Mailing address
950 N 14TH ST, BEAUMONT, TX 77702-1111
(409) 898-6485
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-040392
AL
367500000X
Certified Registered Nurse Anesthetist
536442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G3758
BCBS NON PAR NUMBER
FL
Enumeration date
05/31/2006
Last updated
03/21/2019
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