Organization
BAY AREA UROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY R WAGNER JR. M.D. (OWNER)
(281) 332-9502
Entity
Organization
Contact information
Practice address
8 PROFESSIONAL PARK DR, WEBSTER, TX 77598-4127
(281) 332-9502
(281) 332-6123
Mailing address
PO BOX 58156, HOUSTON, TX 77258-8156
(281) 332-9502
(281) 332-6123
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D5240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093918301
—
TX
Enumeration date
03/28/2007
Last updated
12/03/2010
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