Individual
ROHAN RAVINDRA WAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 AUGUSTA DR, HOUSTON, TX 77057-2209
(713) 442-2400
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q5298
TX
207RC0000X
Cardiovascular Disease Physician
Primary
Q5298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353618701
—
TX
05
—
353618702
—
TX
05
—
353618703
—
TX
Enumeration date
05/13/2008
Last updated
06/23/2021
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