Provider Demographics
NPI:1376535336
Name:RAGAIN, ROGER M (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:M
Last Name:RAGAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8143
Mailing Address - Country:US
Mailing Address - Phone:806-743-2757
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:SUITE 1C143
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8143
Practice Address - Country:US
Practice Address - Phone:806-743-2757
Practice Address - Fax:806-743-2563
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4460207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139335707Medicaid
TX82G885OtherBCBS
NMA028OtherTRIWEST
TX121992103OtherFIRSTCARE COMMERCIAL
NM88667Medicaid
TX139335708Medicaid
NM88667OtherPRESBYTERIAN COMMERCIAL
OK100167930AMedicaid
NMK7959Medicaid
TX121992100Medicaid
TX80801ZOtherHMO BLUE
TX80801ZOtherHMO BLUE
OK100167930AMedicaid
NMK7959Medicaid