Peter G Fagan MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C15552 Issued in TX

Legal business name

PETER G FAGAN MD PA

Practice address

10201 Highway 16
Comanche, TX 76442-4462

Phone

(254) 879-4900

Fax

(254) 879-4989

NPI assigned

Dec 21, 2006

Last updated

Feb 11, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter G Fagan, M.D.NPI 1740205590

Title

Sole Proprietor

Phone

(254) 879-4910

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter G. Fagan, M.D.

  • Family Medicine Physician
  • Comanche, TX
  • NPI 1740205590
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1003970203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "DE LEON",
            "state": "TX",
            "postal_code": "764440488",
            "telephone_number": "254-893-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4900",
            "fax_number": "254-879-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER G FAGAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "254-879-4910",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "C15552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC INDIVIDUAL",
            "identifier": "8F23579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beau L McCrory, M.D.
• Jennifer Robyn McGinnis, FNP
• Tammie Sue McKelvy, LPC
• Dwayne C Miller, M.D.
• Malinda Kaye Padgett, OTR
• Dana Denise Pitman, SLP-CCC
• Barbara L Rhine, RN, MSN
• Roland Thad Roberts
• Ryan L Seegmiller, DDS, PLLC
• Ryan Leo Seegmiller, D.D.S

• Family Medicine Physician in Comanche, TX
• Providers in Comanche, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.