Individual
JOHN HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1501 E MOCKINGBIRD LN STE 220, VICTORIA, TX 77904-2194
(361) 573-2481
(361) 576-2434
Mailing address
1501 E MOCKINGBIRD LN STE 220, VICTORIA, TX 77904-2194
(361) 573-2481
(361) 576-2434
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
586524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742710179A017
CHAMPUS
TX
01
—
88797C
BLUE CROSS
TX
01
—
CR35297
WORKERS COMP
TX
Enumeration date
10/12/2006
Last updated
07/08/2007
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