Organization Active NPI

Kathryn a. Wagner, MD, PA

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1487910014
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
KATHRYN A. WAGNER, MD, PA
Practice address
414 Navarro Street
Suite 1407
San Antonio, TX 78205-2516
Phone
(210) 277-6255
Fax
(210) 277-6256
NPI assigned
Apr 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Dr. Kathryn A Wagner, M.D.
Title
Owner
Phone
(210) 277-6255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

414 Navarro Street
Suite 1407
San Antonio, TX 78205-2516

Mailing address

414 Navarro Street
Suite 1407
San Antonio, TX 78205-2516
Phone (210) 277-6255

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1487910014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 NAVARRO STREET",
            "address_2": "SUITE 1407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-277-6255",
            "fax_number": "210-277-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NAVARRO STREET",
            "address_2": "SUITE 1407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-277-6255",
            "fax_number": "210-277-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN A. WAGNER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-277-6255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.