Provider Demographics
NPI:1750389151
Name:ANGEL, IAN F (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:F
Last Name:ANGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2965 HARRISON ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1100
Mailing Address - Country:US
Mailing Address - Phone:409-898-7800
Mailing Address - Fax:409-898-3295
Practice Address - Street 1:2965 HARRISON ST
Practice Address - Street 2:SUITE 111
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-898-7800
Practice Address - Fax:409-898-3295
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ1843174400000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020HDOtherGROUP BCBS
TX5306425OtherAETNA
TX148913001Medicaid
TX2491021005OtherCIGNA
TX096569104Medicaid
TX8F3761OtherBCBS
TXA002OtherTRICARE/CHAMPUS
TXF11379Medicare UPIN
TX140007874Medicare ID - Type UnspecifiedRAILROAD MEDICARE
TX2491021005OtherCIGNA
TX00024TMedicare ID - Type UnspecifiedGROUP MEDICARE