David Keith Hagstrom, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Odessa, Texas. He went to University Of Oklahoma College Of Medicine and graduated in 1983 and has 43 years of diverse experience with area of expertise as Pain Management. He is a member of the group practice Grace Clinic Of Lubbock and his current practice location is
710 E 6th St, Odessa, Texas. You can reach out to his office (for appointments etc.) via phone at
(254) 245-9175.
David Keith Hagstrom is licensed to practice in Texas (license number H1967) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154493997.
Physician's Profile
| Full Name | David Keith Hagstrom |
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| Gender | Male |
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| Speciality | Pain Management |
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| Experience | 43 Years |
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| Location | 710 E 6th St, Odessa, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- David Keith Hagstrom attended and graduated from University Of Oklahoma College Of Medicine in 1983
NPI Data:
- NPI Number: 1154493997
- Provider Enumeration Date: 11/15/2006
- Last Update Date: 12/08/2025
Medicare PECOS Information:
- PECOS PAC ID: 0345299525
- Enrollment ID: I20050113001160
Medical Identifiers
Medical identifiers for David Keith Hagstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154493997 | NPI | - | NPPES |
| 114307100 | Other | | FIRSTCARE |
| 128109901 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | H1967 (Texas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Grace Clinic Of Lubbock | 5597768101 | 56 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. David Keith Hagstrom allows following entities to bill medicare on his behalf.
| Entity Name | Grace Clinic Of Lubbock |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912953357
PECOS PAC ID: 5597768101
Enrollment ID: O20060822000256 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David Keith Hagstrom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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David Keith Hagstrom, MD
Po Box 610344,
Dallas, TX 75261-0344
Ph: (254) 245-9175 | David Keith Hagstrom, MD
710 E 6th St,
Odessa, TX 79761-4655
Ph: (254) 245-9175 |
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