Provider Demographics
NPI:1144428301
Name:HAGINS, LEE A (RPH)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:A
Last Name:HAGINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:ASPERMONT
Mailing Address - State:TX
Mailing Address - Zip Code:79502-0804
Mailing Address - Country:US
Mailing Address - Phone:940-989-2139
Mailing Address - Fax:940-989-2140
Practice Address - Street 1:616 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ASPERMONT
Practice Address - State:TX
Practice Address - Zip Code:79502
Practice Address - Country:US
Practice Address - Phone:940-989-2139
Practice Address - Fax:940-989-2140
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist