Wagman, Randall
Wagman, Randall is an individual health care provider with primary practice located at 920 Highway 287 N Ste 300, Mansfield TX 76063-2627. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagman, Randall can be contacted via phone (817) 539-0770.Contact Information
Primary practice address
920 Highway 287 N Ste 300
Mansfield TX 76063-2627
Phone: (817) 539-0770
Fax: (817) 539-0772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 11202R | Louisiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M8410 | Texas |
Profile Details
| NPI number | 1225033574 |
|---|---|
| LBN Legal business name | Wagman, Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Feb 14th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225033574 | NPPES |
| Texas | MEDICAID | 197913001 | |
| Texas | MEDICAID | 1667081 |
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