MEDICARE: AGANA ASSOCIATES PA

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	305S00000X	Point of Service	J4680	TX
2	208100000X	Physical Medicine & Rehabilitation Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	250012118	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8A2610	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396771879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGANA ASSOCIATES PA

Provider Business Mailing Address
First Line	:	PO BOX 690687
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77269-0687
Country	:	US
Telephone Number	:	281-419-3366
Fax Number	:	281-580-7583

Provider Business Practice Location Address
First Line	:	13231 CHAMPION FOREST DR STE 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-2646
Country	:	US
Telephone Number	:	281-419-3366
Fax Number	:	281-419-2233

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	BENJAMIN T AGANA JR.
Credential	:	MD
Telephone Number	:	281-419-3366

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	01/29/2025

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Directions to “AGANA ASSOCIATES PA ” Practice Location

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