John Hagan, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

586524 Issued in TX

Practice address

1501 E Mockingbird LN Ste 220
Victoria, TX 77904-2194

Phone

(361) 573-2481

Fax

(361) 576-2434

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851480354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E MOCKINGBIRD LN STE 220",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042194",
            "telephone_number": "361-573-2481",
            "fax_number": "361-576-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E MOCKINGBIRD LN STE 220",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042194",
            "telephone_number": "361-573-2481",
            "fax_number": "361-576-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "JOHN",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "586524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "CR35297",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "88797C",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "742710179A017",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa Renee Gutierrez, PT
• H-E-B, LP (HEB Pharmacy #092)
• H-E-B, LP (HEB Pharmacy #554)
• H. Ellwood Ernst, DDS, Ms, Inc
• Antonio E Hachem, OD
• Lisa Marie Hagan, R.D., L.D.
• Jennifer Marie Hahn, LVN
• Valerie E Hahn, APRN, FNP-C
• Samuel R Haliburton, APRN, FNP-BC
• Susan Delaine Hall, P.A.C.

• Certified Registered Nurse Anesthetist in Victoria, TX
• Providers in Victoria, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.