Provider Demographics
NPI:1578537312
Name:PINA BUGENHAGEN, VERONICA (MD, DVM)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PINA BUGENHAGEN
Suffix:
Gender:F
Credentials:MD, DVM
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:PINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, DVM
Mailing Address - Street 1:PO BOX 132795
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-2795
Mailing Address - Country:US
Mailing Address - Phone:936-273-2016
Mailing Address - Fax:936-273-2018
Practice Address - Street 1:150 PINE FOREST DR STE 703
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-273-2016
Practice Address - Fax:936-273-2018
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036997702Medicaid
TX8B8664OtherBCBS OF TEXAS
H20161Medicare UPIN
TX036997702Medicaid
TX8C9935Medicare PIN
TX8C9936Medicare PIN