Provider Demographics
NPI:1164798591
Name:NAGAN, JOSEPH DAVID (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:NAGAN
Suffix:
Gender:M
Credentials:DO
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 650859 DEPT 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265
Mailing Address - Country:US
Mailing Address - Phone:409-772-1084
Mailing Address - Fax:409-747-1023
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-2353
Practice Address - Country:US
Practice Address - Phone:409-772-2436
Practice Address - Fax:702-671-5198
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2452207RP1001X
NVD02449207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1164798591Medicaid