Provider Demographics
NPI:1831420512
Name:CAGLIA, ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CAGLIA
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 1:670 W. CAMPBELL RD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-690-7070
Mailing Address - Fax:
Practice Address - Street 1:670 W CAMPBELL RD
Practice Address - Street 2:SUITE 150
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3393
Practice Address - Country:US
Practice Address - Phone:972-690-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6216207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C14058Medicare UPIN