Provider Demographics
NPI:1053766998
Name:DR. HERB W AGAN
Entity type:Organization
Organization Name:DR. HERB W AGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLIGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HERB
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:AGAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:713-202-2545
Mailing Address - Street 1:6750 WEST LOOP S
Mailing Address - Street 2:670
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4103
Mailing Address - Country:US
Mailing Address - Phone:713-665-5925
Mailing Address - Fax:
Practice Address - Street 1:6750 WEST LOOP S
Practice Address - Street 2:670
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4103
Practice Address - Country:US
Practice Address - Phone:713-665-5925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 2-2678251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management