Wagner, Richard
Wagner, Richard is an sole proprietor health care provider with primary practice located at 2900 S Loop 256 , Palestine TX 75801-6958. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Wagner, Richard can be contacted via phone (903) 731-1144.Contact Information
Primary practice address
2900 S Loop 256
Palestine TX 75801-6958
Phone: (903) 731-1144
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 35C.001377 | Ohio |
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | J4594 | Texas |
Profile Details
| NPI number | 1881647956 |
|---|---|
| LBN Legal business name | Wagner, Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Apr 2nd, 2024 - about 8 months 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 | 1881647956 | NPPES |
| Texas | MEDICAID | 096949512 | |
| Texas | MEDICAID | 096949513 |
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