Provider Demographics
NPI:1740219260
Name:KAGAN, ARNOLD GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:GERALD
Last Name:KAGAN
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 1:10905 MEMORIAL HERMANN DR
Mailing Address - Street 2:#109
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3490
Mailing Address - Country:US
Mailing Address - Phone:713-436-9200
Mailing Address - Fax:713-436-9707
Practice Address - Street 1:10905 MEMORIAL HERMANN DR
Practice Address - Street 2:#109
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3490
Practice Address - Country:US
Practice Address - Phone:713-436-9200
Practice Address - Fax:713-436-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1693208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111590901Medicaid
TXF1693OtherLICENSE
TX111590901Medicaid