Individual
DR. WAYNE A FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4141 S. STAPLES SUITE 300, CORPUS CHRISTI, TX 78411-2929
(361) 882-5560
(361) 882-6011
Mailing address
4141 S. STAPLES SUITE 300, CORPUS CHRISTI, TX 78411-2155
(361) 882-5560
(361) 882-6011
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
J4105
TX
207ND0900X
Dermatopathology Physician
45D0913782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040EE
BLUE CROSS BLUE SHIELD
TX
01
—
070017610
MEDICARE RAILROAD
TX
05
—
080856001
—
TX
01
—
1356536494
GROUP NPI #
TX
01
—
86470Y
BLUE CROSS
TX
01
—
CK7292
MEDICARE RAILROAD
TX
Enumeration date
06/22/2005
Last updated
05/16/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us