Organization Name: | CHARLES L WAGNON MD PA |
NPI Number: | 1023067527 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES LEE WAGNON (OWNER) |
Mailing Address: | 777 E Wheatland Rd Suite 102 Duncanville |
State: | TX US |
Postal Code: | 75116 |
Phone Number: | 9722984981 |
Fax Number: | 9722984984 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 10/22/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | D4346 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |