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General NPI Number Information
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NPI Number | 1154332575
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Entity Type | Individual
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Provider Name | ELIZABETH LOUISE FAGAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 02/11/2013
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Provider Practice Location Address
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Address Line | 5252 W UNIVERSITY DR
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City | MCKINNEY
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State | TX
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Zip | 75071-7822
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Country | US
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Telephone | 469-764-5059
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Fax |
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Provider Business Mailing Address
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Address Line | 760 STINSON RD
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City | ALLEN
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State | TX
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Zip | 75002-7312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K5924
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License Number State | TX
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