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NPI Code Detail

MEDICARE: IAN KEITH PAGDILAO LPC, NCC

MEDICARE: IAN KEITH PAGDILAO LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor81158TX
2101YP2500XProfessional Counselor81158TX

General Provider Information

NPI Number : 1306438114
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN KEITH PAGDILAO LPC, NCC
Provider Business Mailing Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2021
Last Update Date : 01/08/2026

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