Provider Demographics
NPI:1659591022
Name:ROUX, NAPOLEON PANGAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:NAPOLEON
Middle Name:PANGAN
Last Name:ROUX
Suffix:III
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 1:3551 ROGER BROOKE DRIVE
Mailing Address - Street 2:QUALITY SERVICES/7TH FLOOR, ATTN: MCHE-ZQQ
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-2888
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:QUALITY SERVICES/7TH FLOOR, ATTN: MCHE-ZQQ
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-916-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239920207L00000X
TXS3289207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4897, 16NBSOOtherCARE FIRST BC/BS NCA & MARYLAND
MD410565600Medicaid
MDCG1279OtherRAILROAD MEDICARE
MD037965900OtherD.C. MEDICAID
MD4897, 16NBSOOtherCARE FIRST BC/BS NCA & MARYLAND