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General NPI Number Information
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NPI Number | 1366853558
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Entity Type | Individual
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Provider Name | WHITNEY SMITH HAGAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2014
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 5924 ROYAL LANE SUITE 216
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City | DALLAS
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State | TX
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Zip | 75230
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Country | US
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Telephone | 214-305-6890
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Fax | 214-377-5043
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Provider Business Mailing Address
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Address Line | 6334 VELASCO AVENUE
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City | DALLAS
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State | TX
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Zip | 75214
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Country | US
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Telephone | 646-337-7792
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | R6790
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License Number State | TX
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