Provider Demographics
NPI:1598700551
Name:MAUGER, MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MAUGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2901
Mailing Address - Country:US
Mailing Address - Phone:361-993-3917
Mailing Address - Fax:361-993-4336
Practice Address - Street 1:6009 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2901
Practice Address - Country:US
Practice Address - Phone:361-993-3917
Practice Address - Fax:361-993-4336
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131375363LF0000X
TX3033DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A8980OtherBLUE CROSS
TX601443Medicare ID - Type Unspecified
TX8A8980OtherBLUE CROSS