| NPI | 1285903179 |
|---|---|
| Other Name | WAYNE A FAGAN MD |
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN VINCENT Business Manager 361-882-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX J4105) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |