Organization
SOUTH TEXAS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL WAGGONER M.D. (MEDICAL DIRECTOR)
(214) 374-2880
Entity
Organization
Contact information
Practice address
2506 S LANCASTER RD, DALLAS, TX 75216-2532
(214) 374-2880
(214) 374-2853
Mailing address
2506 S LANCASTER RD, DALLAS, TX 75216-2532
(214) 374-2880
(214) 374-2853
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
J4593
TX
Other
Enumeration date
02/23/2007
Last updated
08/22/2020
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