William W Wagnon MD PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

F2087 Issued in TX

Legal business name

WILLIAM W WAGNON MD PA

Practice address

2801 S John Redditt Dr
Suite B
Lufkin, TX 75904-5666

Phone

(936) 632-6111

Fax

(936) 632-9182

NPI assigned

Apr 17, 2007

Organization subpart

Yes

Parent organization

WILLIAM W. WAGNON MD PAAs reported in NPPES

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

Authorized official

Name

Dr. William W Wagnon, MDNPI 1902895345

Title

Owner

Phone

(936) 632-6111

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Richard H Weatherall M

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Wright Wagnon

  • Ophthalmology Physician
  • Lufkin, TX
  • NPI 1902895345
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1619192192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "address_2": "SUITE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-632-6111",
            "fax_number": "936-632-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "address_2": "SUITE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-632-6111",
            "fax_number": "936-632-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM W WAGNON MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM W. WAGNON MD PA",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "WAGNON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-632-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8596-TG",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093898701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1902895345",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WHS OBGYN PLLC
• Monique Wicker
• Mark Edward Wiedenfeld, O.D.
• Patricia Wilkerson
• Steven Wilks
• Derek Williams, DDS
• Johnathan Fred Williams, M.D.
• Tyra Williams
• Williamson Family Health
• Hobart Reynolds Williamson, LPC

• Ophthalmology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.