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Individual

DR. RAYMOND L WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.D.

Contact information

Practice address
810 S MASON RD, STE 301, KATY, TX 77450-3858
(281) 395-1200
(281) 395-1207
Mailing address
810 S MASON RD, SUITE 301, KATY, TX 77450-3895
(281) 395-1200
(281) 395-1207

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
18986
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164989
DBP
TX
01
509663782
UCCI
TX
01
51107
ASSURANT
TX
01
88D134
BC/BS ID
TX
Enumeration date
09/29/2005
Last updated
03/05/2013
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