Organization
CHARLES L WAGNON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES LEE WAGNON MD (OWNER)
(972) 298-4981
Entity
Organization
Contact information
Practice address
777 E WHEATLAND RD, SUITE 102, DUNCANVILLE, TX 75116
(972) 298-4981
(972) 298-4984
Mailing address
777 E WHEATLAND RD, SUITE 102, DUNCANVILLE, TX 75116
(972) 298-4981
(972) 298-4984
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D4346
TX
Other
Enumeration date
05/10/2006
Last updated
10/22/2007
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