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General NPI Number Information
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NPI Number | 1669661070
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Entity Type | Individual
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Provider Name | ANGELA RENE HAGUE PA
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 7777 FOREST LANE SUITE B332
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City | DALLAS
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State | TX
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Zip | 75230-6822
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Country | US
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Telephone | 972-566-7788
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Fax | 972-566-8837
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Provider Business Mailing Address
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Address Line | PO BOX 1810
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City | SKYLAND
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State | NC
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Zip | 28776-1810
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Country | US
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Telephone | 828-575-2644
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Fax | 828-350-2174
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA03936
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License Number State | TX
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