Active NPI
Kacy Lamar Wagne, PHARM.D.
- Pharmacist
- Corpus Christi, TX
National Provider Identifier
1811095748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 41074
- Practice address
- 5283 Old Brownsville Rd
Corpus Christi, TX 78405-3908 - Phone
- (361) 806-5612
- Fax
- (361) 806-5616
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 41074 | TX | Primary |
Addresses
Primary practice location
5283 Old Brownsville Rd
Corpus Christi, TX 78405-3908
Mailing address
6914 Sir Palleas
Corpus Christi, TX 78413-5303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41074 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1811095748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6914 SIR PALLEAS",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784135303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5283 OLD BROWNSVILLE RD",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784053908",
"telephone_number": "361-806-5612",
"fax_number": "361-806-5616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNE",
"first_name": "KACY",
"middle_name": "LAMAR",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "41074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.