Provider Demographics
NPI:1356340574
Name:DUGAN, JOHN T II (MD FAAO PA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:DUGAN
Suffix:II
Gender:M
Credentials:MD FAAO PA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3827
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78463-3827
Mailing Address - Country:US
Mailing Address - Phone:361-884-8878
Mailing Address - Fax:361-884-2020
Practice Address - Street 1:900 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2028
Practice Address - Country:US
Practice Address - Phone:361-888-4288
Practice Address - Fax:361-888-4293
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE1306207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPO84V0704Medicaid
TX74-2683083OtherTAX ID
TX742021064OtherTAX ID
TX4176400001Medicare NSC
TXB87565Medicare UPIN
TXPO84V0704Medicaid