Organization Active NPI

Charles L Wagnon MD PA

  • Obstetrics & Gynecology Physician
  • Duncanville, TX
National Provider Identifier
1023067527
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D4346 Issued in TX
Legal business name
CHARLES L WAGNON MD PA
Practice address
777 E Wheatland Rd
Suite 102
Duncanville, TX 75116
Phone
(972) 298-4981
Fax
(972) 298-4984
NPI assigned
May 10, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Charles Lee Wagnon, MDNPI 1457391617
Title
Owner
Phone
(972) 298-4981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X D4346 TX Primary

Addresses

Primary practice location

777 E Wheatland Rd
Suite 102
Duncanville, TX 75116

Mailing address

777 E Wheatland Rd
Suite 102
Duncanville, TX 75116
Phone (972) 298-4981

National Provider Directory

National Provider Directory

Locations

777 E Wheatland Rd
Ste 102
Duncanville, TX 75116
Phone (972) 298-4981

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1023067527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E WHEATLAND RD",
            "address_2": "SUITE 102",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "75116",
            "telephone_number": "972-298-4981",
            "fax_number": "972-298-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E WHEATLAND RD",
            "address_2": "SUITE 102",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "75116",
            "telephone_number": "972-298-4981",
            "fax_number": "972-298-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L WAGNON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "WAGNON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-298-4981",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "D4346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.