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WAYNE A FAGAN MD
NPI 1285903179
Specialist in Corpus Christi, TX

Active since December 21, 2011CLIA 45D0913782 · Certificate of Compliance
1300 THIRD STREET, CORPUS CHRISTI, TX 78404(361) 882-5560(361) 882-6011 Get Directions Write a Review

NPPES record last updated: December 21, 2011. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Wayne A Fagan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAYNE A FAGAN MD (NPI 1285903179) is a healthcare organization registered as a specialist in Corpus Christi, Texas and active in the NPI registry since December 2011. The organization holds a CLIA Certificate of Compliance certificate valid through June 9, 2028 and lists Jennifer Lynn Vincent, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1285903179
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTH TEXAS DERMATOLOGY PLLC
Location Address1300 THIRD STREETCorpus Christi, TX 78404
Mailing Address1300 Third StreetCorpus Christi, TX 78404 · (361) 882-5560 · Fax (361) 882-6011
Phone(361) 882-5560
Fax(361) 882-6011
Organization SubpartNo
Authorized OfficialJennifer Lynn VincentBusiness Manager · (361) 882-2338
Enumeration DateDecember 21, 2011
✔ NPI 1285903179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · J4105
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1300 THIRD STREET, Corpus Christi, TX 78404
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Other Names 1

Other NameWayne A Fagan Md

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 45D0913782

South Texas Dermatology · Corpus Christi, TX
Active · expires Jun 9, 2028
CLIA Number45D0913782
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2026
Certificate Expiration DateJune 9, 2028
Laboratory DirectorWayne A. Fagan MD
Laboratory Phone(361) 882-5560
Laboratory LocationSouth Texas Dermatology4141 South Staples #300, Corpus Christi, TX 78411
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Texas Dermatology PLLC's NPI number?

The NPI number for South Texas Dermatology PLLC is 1285903179. It was assigned to this organization in the NPPES registry on December 21, 2011. The provider is also known as Wayne A Fagan MD.

Where is South Texas Dermatology PLLC located?

South Texas Dermatology PLLC is located at 1300 Third Street, Corpus Christi, TX 78404. The listed phone number is (361) 882-5560.

What is South Texas Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does South Texas Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D0913782) is associated with this NPI, valid through June 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Texas Dermatology PLLC was last updated on December 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.