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NPI Code Detail

MEDICARE: JAMES MICHAEL HAGAR PT

MEDICARE:   JAMES MICHAEL HAGAR  PT
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
1225100000XPhysical Therapist1163353TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T4554OTHERTXBCBS PROVIDER #

General Provider Information

NPI Number : 1568531259
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MICHAEL HAGAR PT
Provider Business Mailing Address
First Line : PO BOX 29
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75483-0029
Country : US
Telephone Number : 903-885-9906
Fax Number : 903-438-9636
Provider Business Practice Location Address
First Line : 1129 INDUSTRIAL DR E
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-3326
Country : US
Telephone Number : 903-885-9906
Fax Number : 903-438-9636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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