Provider Demographics
NPI:1972837516
Name:HAGEN, BARBARA ALICE (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ALICE
Last Name:HAGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ALICE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2401 S 31ST ST
Mailing Address - Street 2:SCOTT AND WHITE CLINIC
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7115
Mailing Address - Country:US
Mailing Address - Phone:254-939-1647
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:SCOTT AND WHITE CLINIC
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7115
Practice Address - Country:US
Practice Address - Phone:254-724-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8861208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics