Harold G Wagner, D.O.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

H6679 Issued in TX

Practice address

7441 Marvin D Love Fwy
Ste 300
Dallas, TX 75237-3490

Phone

(972) 572-1998

Fax

(972) 572-4842

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Harold Wagner DO PA

  • Geriatric Medicine (Family Medicine) Physician
  • Dallas, TX
  • NPI 1255438701
  NPD (past) Authorized official
• Gaven, P.a.

  • General Acute Care Hospital
  • Rockwall, TX
  • NPI 1093803603
  NPD (past)
• Imur Family Medical

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1487815718
  NPD (past)
• Indelible Health & Wellness LLC

  • Family Medicine Physician
  • Grand Prairie, TX
  • NPI 1245569946
  NPD (past)
• Texas Em-1 Medical Services PA

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1659446193

  Emergency Medicine

  NPD (past)
• Texas Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Paris, TX
  • NPI 1376715268

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1114015138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7441 MARVIN D LOVE FWY",
            "address_2": "STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373490",
            "telephone_number": "972-572-1998",
            "fax_number": "972-572-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7441 MARVIN D LOVE FWY",
            "address_2": "STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373490",
            "telephone_number": "972-572-1998",
            "fax_number": "972-572-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HAROLD",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H6679",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "H6679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00207035",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "008PH",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140123437",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blair Faram Wagner, M.S., CCC-SLP
• Christine W Wagner, NP
• Denise Maragos Wagner, RN
• Durand Wagner, CRNA
• Erica Lynn Wagner, CRNA
• James Michael Wagner, MD
• Jason Wagner
• Jennifer Marie Wagner, MD
• Kaleena Wagner, CGC
• Kurt John Wagner III, MD, MBA

• All providers in Dallas, TX
• Geriatric Medicine (Internal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.