WAYNE A FAGAN MD
NPI 1285903179
Specialist in Corpus Christi, TX
NPI Status: Active since December 21, 2011
Contact Information
1300 THIRD STREET
CORPUS CHRISTI, TX
ZIP 78404
Phone: (361) 882-5560
Fax: (361) 882-6011
- Organization
- Specialist
- CLIA Number: 45D0913782
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-09-2026
About WAYNE A FAGAN MD
This page provides the complete NPI Profile along with additional information for Wayne A Fagan Md, a provider established in Corpus Christi, Texas operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1285903179 assigned on December 2011. The practitioner's primary taxonomy code is 174400000X with license number J4105 (TX). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's other name is Wayne A Fagan Md. The authorized official of this NPI record is Mr. Jennifer Lynn Vincent Cdc (Business Manager)
- NPI
- 1285903179
- Provider Legal Name
- SOUTH TEXAS DERMATOLOGY PLLC
- Other Organization Name
- WAYNE A FAGAN MD
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 1300 THIRD STREET CORPUS CHRISTI, TX 78404
- Location Phone
- (361) 882-5560
- Location Fax
- (361) 882-6011
- Mailing Address
- 1300 THIRD STREET CORPUS CHRISTI, TX 78404
- Mailing Phone
- (361) 882-5560
- Mailing Fax
- (361) 882-6011
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-21-2011
- Last Update Date
- 12-21-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- J4105
- License State
- TX
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D0913782
- Facility Type
- Physician Office
- Certificate Effective Date
- June 10, 2024
- Certificate Expiration Date
- June 09, 2026
- Laboratory Director
- WAYNE A. FAGAN MD
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Wayne A Fagan Md after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1285903179, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285903179, enumerated as an "organization" on December 21, 2011.
The provider is located at 1300 THIRD STREET CORPUS CHRISTI, TX 78404 and the phone number is (361) 882-5560.
Specialist with taxonomy code 174400000X.
