Provider Demographics
NPI:1548279144
Name:HAGER, ERIK M (OTR)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:M
Last Name:HAGER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 W HIDALGO AVE
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-3529
Mailing Address - Country:US
Mailing Address - Phone:956-689-1000
Mailing Address - Fax:956-689-6026
Practice Address - Street 1:464 W HIDALGO AVE
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-3529
Practice Address - Country:US
Practice Address - Phone:956-689-1000
Practice Address - Fax:956-689-6026
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109956225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6370 BC/BSOtherOCCUPATIONAL THERAPIST RE
TX8T6370 BC/BSOtherOCCUPATIONAL THERAPIST RE
TX8F2056 PART BMedicare ID - Type UnspecifiedOCCUPATIONAL THERAPIST RE