Provider Demographics
NPI:1366853558
Name:HAGAN, WHITNEY SMITH (MD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:SMITH
Last Name:HAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WHITNEY
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6334 VELASCO AVENUE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214
Mailing Address - Country:US
Mailing Address - Phone:646-337-7792
Mailing Address - Fax:
Practice Address - Street 1:5924 ROYAL LANE
Practice Address - Street 2:SUITE 216
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:214-305-6890
Practice Address - Fax:214-377-5043
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-10
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR67902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry