Mr Kenneth W Wagner, PA-C in Houston, TX - Medicare Physician Assistant

Mr Kenneth W Wagner, PA-C is a medicare enrolled "Physician Assistant" in Houston, Texas. His current practice location is 17115 Red Oak Dr, Suite 211, Houston, Texas. You can reach out to his office (for appointments etc.) via phone at (281) 719-9681.

Mr Kenneth W Wagner is licensed to practice in Texas (license number PA00865) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1700804309.

Contact Information

	Mr Kenneth W Wagner, PA-C
	17115 Red Oak Dr, Suite 211, Houston, TX 77090-2641
	(281) 719-9681
	(281) 791-0059

Map and Direction

Provider's Profile

Full Name	Mr Kenneth W Wagner
Gender	Male
Speciality	Physician Assistant
Location	17115 Red Oak Dr, Houston, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700804309
Provider Enumeration Date: 07/18/2006
Last Update Date: 04/29/2021

Medicare PECOS Information:

PECOS PAC ID: 4486717923
Enrollment ID: I20090109000633

Medical Identifiers

Medical identifiers for Mr Kenneth W Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700804309	NPI	-	NPPES
8Y8598	Other	TX	BCBSTX
198928701	Medicaid	TX
87N250	Other	TX	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AS0400X	Physician Assistant - Surgical	PA00865 (Texas)	Secondary
363AS0400X	Physician Assistant - Surgical	(* (Not Available))	Secondary
363A00000X	Physician Assistant	PA00865 (Texas)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kenneth W Wagner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Kenneth W Wagner, PA-C 17070 Red Oak Dr, Ste 507, Houston, TX 77090-2617 Ph: (281) 719-9681	Mr Kenneth W Wagner, PA-C 17115 Red Oak Dr, Suite 211, Houston, TX 77090-2641 Ph: (281) 719-9681

Reviews and Comments

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Mr Kenneth W Wagner, PA-C - Medicare Physician Assistant in Houston, TX