Individual
JEFF E. HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
174400000X
Specialist
G3424
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
G2434
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041869104
—
TX
Enumeration date
01/04/2006
Last updated
02/20/2013
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