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Individual

DR. RICHARD DOWNS WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3801 GASTON AVE STE 200, DALLAS, TX 75246-2536
(214) 823-9630
Mailing address
PO BOX 612526, DALLAS, TX 75261-2526
(972) 256-3700
(866) 630-6348

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R6704
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200784810A
OK
05
388111201
TX
05
388111202
TX
05
99526751
NM
Enumeration date
04/28/2014
Last updated
04/30/2025
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