Individual provider Active NPI

Wais Patan Wardag, MD

  • Pediatrics Physician
  • Hutto, TX
National Provider Identifier
1659001964
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP10078881 Issued in TX
Practice address
123 Ed Schmidt Blvd Ste 140
Hutto, TX 78634-5586
Phone
(877) 800-5722
NPI assigned
Jun 10, 2022
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10078881 TX Primary
Pediatrics Physician 208000000X V9171 TX

Addresses

Primary practice location

123 Ed Schmidt Blvd Ste 140
Hutto, TX 78634-5586

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other practice location 1

4900 Mueller Blvd Ste 3K.032
Austin, TX 78723-3051
Phone (512) 324-0067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117003565 TX Practitioner - Pediatric Medicine 2961840293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2423 Williams Dr
Suite 107
Georgetown, TX 78628-3269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10078881TXMDPediatrics Physician
V9171TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Nov 10, 2025 Accepting new patients
Lone Star Circle of Care Pediatrics Current Accepting new patients
Lone Star Circle of Care CurrentSince Nov 10, 2025 Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 686-0207

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

123 Ed Schmidt Blvd
Ste 140
Hutto, TX 78634
Phone (806) 786-2795

Interoperability endpoints

  • Direct secure messaging: wais.wardag.1@29821.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1659001964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ED SCHMIDT BLVD STE 140",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786345586",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Mueller Blvd Ste 3K.032",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787233051",
            "country_code": "US",
            "telephone_number": "512-324-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDAG",
        "first_name": "WAIS",
        "middle_name": "PATAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10078881",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V9171",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutto, TX

Sources for this page

Verify at the official NPI Registry.