Provider Demographics
NPI:1104389220
Name:PAGANO CLINIC, LLC
Entity Type:Organization
Organization Name:PAGANO CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-358-7777
Mailing Address - Street 1:1524 KINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3042
Mailing Address - Country:US
Mailing Address - Phone:281-358-7777
Mailing Address - Fax:281-973-8039
Practice Address - Street 1:1524 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3042
Practice Address - Country:US
Practice Address - Phone:281-358-7777
Practice Address - Fax:281-973-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty