MEDICARE: RAEGAN PENNELL RAGUSE L.AC, DACCHM

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
1	171100000X	Acupuncturist	AC02242	TX

General Provider Information

NPI Number	:	1881546604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAEGAN PENNELL RAGUSE L.AC, DACCHM

Provider Business Mailing Address
First Line	:	321 WINDMILL RANCH RD
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78633-5739
Country	:	US
Telephone Number	:	512-818-4949
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 RIVER HILLS DR STE 6
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-5308
Country	:	US
Telephone Number	:	512-818-4949
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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