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Individual

WILLIAM WRIGHT WAGNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2801 S JOHN REDDITT DR, SUITE B, LUFKIN, TX 75904-5666
(936) 632-6111
(936) 632-9182
Mailing address
2801 S JOHN REDDITT DR, SUITE B, LUFKIN, TX 75904-5666
(936) 632-6111
(936) 632-9182

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F2087
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093898701
TX
Enumeration date
10/18/2005
Last updated
11/08/2011
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