Provider Demographics
NPI:1366483257
Name:VICTORIA WOMEN'S CLINIC ASSOCIATES
Entity Type:Organization
Organization Name:VICTORIA WOMEN'S CLINIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-578-5233
Mailing Address - Street 1:110 MEDICAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3126
Mailing Address - Country:US
Mailing Address - Phone:361-578-5233
Mailing Address - Fax:
Practice Address - Street 1:110 MEDICAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3126
Practice Address - Country:US
Practice Address - Phone:361-578-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N346Medicare ID - Type UnspecifiedGROUP'S MEDICARE NUMBER