Provider Demographics
NPI:1083733257
Name:DONALD E. CAGLE, M.D.
Entity Type:Organization
Organization Name:DONALD E. CAGLE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-569-6411
Mailing Address - Street 1:320 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1240
Mailing Address - Country:US
Mailing Address - Phone:936-569-6411
Mailing Address - Fax:936-569-6446
Practice Address - Street 1:320 RUSSELL BLVD
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1240
Practice Address - Country:US
Practice Address - Phone:936-569-6411
Practice Address - Fax:936-569-6446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0021JKOtherBCBS GRP
TX0021JKOtherBCBS GRP