Healthcare Provider Details

I. General information

NPI: 1053193847
Provider Name (Legal Business Name): CORRIGAN MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W BEN FRANKLIN ST
CORRIGAN TX
75939-2042
US

IV. Provider business mailing address

207 W BEN FRANKLIN ST
CORRIGAN TX
75939-2042
US

V. Phone/Fax

Practice location:
  • Phone: 936-398-5555
  • Fax: 936-398-5559
Mailing address:
  • Phone: 936-398-5555
  • Fax: 936-398-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOANNA BLEDSOE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 936-398-5555