Wagner, Donna Rm
Wagner, Donna Rm is an individual health care provider with primary practice located at 1501 E Mockingbird Ln #101, Victoria TX 77904-2155. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Wagner, Donna Rm can be contacted via phone (361) 513-6291.Contact Information
Primary practice address
1501 E Mockingbird Ln #101
Victoria TX 77904-2155
Phone: (361) 513-6291
Fax: (361) 576-2434
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | J0338 | Texas |
Profile Details
| NPI number | 1487743969 |
|---|---|
| LBN Legal business name | Wagner, Donna Rm |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Sep 7th, 2016 - about 8 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 | 1487743969 | NPPES |
| Texas | Other | 742710179A011 | CHAMPUS |
| Texas | Other | MDJ0338TX | CHAMPUS |
| Texas | MEDICAID | 123558203 | CHAMPUS |
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