Provider Demographics
NPI:1396771879
Name:AGANA ASSOCIATES PA
Entity type:Organization
Organization Name:AGANA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:AGANA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:281-419-3366
Mailing Address - Street 1:PO BOX 690687
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-0687
Mailing Address - Country:US
Mailing Address - Phone:281-419-3366
Mailing Address - Fax:281-580-7583
Practice Address - Street 1:13231 CHAMPION FOREST DR STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2646
Practice Address - Country:US
Practice Address - Phone:281-419-3366
Practice Address - Fax:281-419-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4680305S00000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A2610OtherBCBS
TX096845503Medicaid
TX250012118OtherMEDICARE RAILROAD
TX250012118OtherMEDICARE RAILROAD