Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | J4460 | TX |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | J4460 | TX |
NPI | 1376535336 |
---|---|
Provider Name | Roger M. Ragain |
First Address | Lubbock, TX 79430-8143 |
Second Address | Lubbock, TX 79430-8143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 13/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100167930A | (05) | OK |
121992100 | (05) | TX |
121992103 | FIRSTCARE COMMERCIAL (01) | TX |
139335707 | (05) | TX |
139335708 | (05) | TX |
80801Z | HMO BLUE (01) | TX |
82G885 | BCBS (01) | TX |
88667 | (05) | NM |
88667 | PRESBYTERIAN COMMERCIAL (01) | NM |
A028 | TRIWEST (01) | NM |
F65725 | (02) | TX |
K7959 | (05) | NM |