Provider Demographics
NPI:1275175887
Name:PAGAN, ANGEL VIRGILIO (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:VIRGILIO
Last Name:PAGAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 FORNEY LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-1607
Mailing Address - Country:US
Mailing Address - Phone:915-317-6033
Mailing Address - Fax:
Practice Address - Street 1:3101 FORNEY LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-1607
Practice Address - Country:US
Practice Address - Phone:915-317-6033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily