Matthew Darby Wagoner, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

37261 Issued in TX

Practice address

511 N Hewitt Dr Ste 1
Hewitt, TX 76643-3093

Phone

(254) 666-5000

Fax

(254) 666-5002

NPI assigned

Dec 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hewitt Drug

  • Community/Retail Pharmacy
  • Hewitt, TX
  • NPI 1205278686
  NPD (past) Authorized official
• Hewitt Drug

  • Long Term Care Pharmacy
  • Hewitt, TX
  • NPI 1962022442
  NPD

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1033705363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N HEWITT DR STE 1",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433093",
            "telephone_number": "254-733-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N HEWITT DR STE 1",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433093",
            "telephone_number": "254-666-5000",
            "fax_number": "254-666-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "MATTHEW",
        "middle_name": "DARBY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "37261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Hewitt, TX
• Providers in Hewitt, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.