Tara T Wagner, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

N2876 Issued in TX

Practice address

3501 Mills Ave
Austin, TX 78731

Phone

(512) 324-2080

NPI assigned

Jun 4, 2007

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Tri-County Clinical

  • Family Medicine Physician
  • Luling, TX
  • NPI 1336456227
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1144422098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 TRINITY ST STOP Z0200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121850",
            "telephone_number": "512-495-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 MILLS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-324-2080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3614 Bill Price Rd",
            "address_2": "Health Services Building",
            "address_purpose": "LOCATION",
            "city": "Del Valle",
            "state": "TX",
            "postal_code": "786173630",
            "country_code": "US",
            "telephone_number": "512-854-4182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TARA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N2876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Wagner, MS, CCC-SLP
• Leon R Wagner, DC
• Nicholas J. Wagner, MD
• Rebecca Ann Wagner, PHD
• Sarah Elizabeth Rene Wagner, LPC
• Wayne Louis Wagner, DDS
• Emily Wagoner
• Christopher S Wahal, M.D.
• Sameer Waheed, M.D
• Chelsea Renee Wahl

• Psychiatry Physician in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.