Provider Demographics
NPI:1730395385
Name:VIRGINIA MCDOUGALL MD, PA
Entity type:Organization
Organization Name:VIRGINIA MCDOUGALL MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:361-986-9800
Mailing Address - Street 1:5833 SPOHN DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4135
Mailing Address - Country:US
Mailing Address - Phone:361-986-9800
Mailing Address - Fax:361-986-9803
Practice Address - Street 1:5833 SPOHN DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4135
Practice Address - Country:US
Practice Address - Phone:361-986-9800
Practice Address - Fax:361-986-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3015174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG96428Medicare UPIN
TX00W238Medicare ID - Type Unspecified