Organization
HAROLD WAGNER DO PA
Active
Other names
Home Care Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD G WAGNER D.O. (PRESIDENT)
(214) 434-4031
Entity
Organization
Contact information
Practice address
7441 MARVIN D LOVE FWY, SUITE 300, DALLAS, TX 75237-3490
(972) 572-1998
(942) 572-4842
Mailing address
7441 MARVIN D LOVE FWY, SUITE 300, DALLAS, TX 75237-3490
(972) 572-1998
(942) 572-4842
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1754905 01
—
TX
01
—
DC9723
RAILROAD MEDICARE
TX
Enumeration date
09/19/2006
Last updated
03/10/2010
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